Endobronchial-ultrasound Needle Aspiration Combing With Endoscopic Ultrasound-fine-needle Aspiration In Lymphoma Diagnosis And Subtype Classification
L. Zhanga (Dr), S. Hea (Dr), YM. Zhanga (Dr), L. Wangb (Dr), GQ. Wang*a (Dr)
a National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, CHINA ; b National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, CHINA
* wangguiq@126.com
Background
EBUS-TBNA and EUS-FNA are efficient and safe approaches in the assessment of undefined deep-seated lesions, especially in neoplasm. However, the application of EBUS-TBNA and EUS-FNA in lymphoma diagnosis remains undetermined and unrecognized. In this study, we evaluate the role of EBUS-TBNA combing with EUS-FNA in lymphoma diagnosis and subtype classification.
Methods
We retrieved the database of all patients undergoing EBUS-TBNA or EUS-FNA in the department of Endoscopy, National Cancer Center/Cancer Hospital from January 2008 to June 2021 and identified patients with suspected or diagnosed lymphoma. A retrospective analysis was performed, and clinical data were carefully studied.
Results
A total of 4,121 patients underwent endoscopic ultrasound-guided puncture, including 2,501 cases of EBUS-TBNA and 1,620 cases of EUS-FNA. Among these patients, 192 were suspected of lymphoma, therefore 123 underwent EBUS-TBNA and 69 underwent EUS-FNA. Consequently, 51 patients（26.56%）were diagnosed with lymphoma, including 29 patients diagnosed by EBUS-TBNA and 22 patients by EUS-FNA. The overall sensitivity of ultrasound-guided endoscopic puncture for lymphoma diagnosis was 62.75%. The sensitivity of EUS-FNA (72.73%) was likely higher than those of EBUS-TBNA (55.17%), but the difference was not statistically significant (p = 0.199). The negative predictive values of EBUS-TBNA and EUS-FNA were 87.85% and 88.68% (P=0.879), respectively. The specificity rates and positive predictive values of both groups were 100%. Among 29 new-onset cases, 20 (68.97%) were classified as lymphoma subtypes. Thirteen cases were initially diagnosed by EBUS-TBNA, of which 10 (76.92%) were specifically classified. In addition, 16 lymphoma cases were initially diagnosed by EUS-FNA, of which 10 (62.5%) were classified. One patient experienced fever after EUS-FNA was cured by conservative method.
Conclusion
EBUS-TBNA combing with EUS-FNA is an effective, minimally invasive diagnostic method for patients with suspected lymphoma. These two approaches are similar in lymphoma diagnosis and valuable in classifying lymphoma subtypes.
Disclosure of funding source(s):
This work was supported by Sanming Project of Medicine in Shenzhen [grant number SZSM201911008].