Abstract | BACKGROUND: Few prospective studies have evaluated the role of endobronchial needle aspiration in diagnosing central airways neoplasms. Rapid on-site evaluation has long been used in transbronchial needle aspiration of adenopathies and peripheral lesions, but its role in sampling central malignancies has not been substantiated yet. OBJECTIVES: In this study we evaluated if endobronchial needle aspiration may increase the sensitivity of bronchoscopy for diagnosing central airways neoplasms when added to conventional diagnostic methods ( forceps biopsy, brushing and bronchial washing), and if rapid on-site evaluation may be beneficial in patients undergoing endobronchial needle aspiration. METHODS: 125 patients (77% males, aged 70 ± 7 years; mean ± SD) with central lung cancers were randomized to undergo bronchoscopy including conventional diagnostic methods and needle aspiration, with or without rapid on-site evaluation, stratifying the patients on the basis of the neoplasm growth pattern (exophytic and submucosal/peribronchial disease). RESULTS: Needle aspiration significantly increased the sensitivity of bronchoscopy when added to conventional methods (from 76 to 91%; p < 0.001), primarily resulting from differences in submucosal/peribronchial diseases (68 vs. 90%; p < 0.001) and independently from the presence of rapid on-site evaluation; needle aspiration guided by rapid on-site evaluation guaranteed a higher improvement in bronchoscopy sensitivity than conventional needle aspiration (98 vs. 84%, respectively; p = 0.004). Needle aspiration guided by rapid on-site evaluation showed a significantly higher sensitivity than the conventional method (97 vs. 76%, respectively; p = 0.001). CONCLUSIONS: Needle aspiration increases the sensitivity of bronchoscopy in diagnosing central airways malignancies when added to conventional diagnostic methods, with a further significant improvement when guided by rapid on-site evaluation.
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Authors | Michele Mondoni, Paolo Carlucci, Fabiano Di Marco, Stefania Rossi, Pierachille Santus, Alice D'Adda, Giuseppe Francesco Sferrazza Papa, Gaetano Bulfamante, Stefano Centanni |
Journal | Respiration; international review of thoracic diseases
(Respiration)
Vol. 86
Issue 1
Pg. 52-8
( 2013)
ISSN: 1423-0356 [Electronic] Switzerland |
PMID | 23594935
(Publication Type: Journal Article, Randomized Controlled Trial)
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Copyright | Copyright © 2013 S. Karger AG, Basel. |
Topics |
- Adenocarcinoma
(diagnosis, pathology)
- Aged
- Biopsy, Needle
(methods)
- Bronchi
(pathology)
- Bronchoalveolar Lavage
- Bronchoscopy
(methods)
- Carcinoma, Squamous Cell
(diagnosis, pathology)
- Female
- Humans
- Lung Neoplasms
(diagnosis, pathology)
- Male
- Middle Aged
- Sensitivity and Specificity
- Small Cell Lung Carcinoma
(diagnosis, pathology)
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