Objective: To investigate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with mediastinal lesions and previously conventional TBNA-negative results.
Methods: A total of 403 patients with mediastinal lesions on chest CT but negative results of routine bronchoscopy were enrolled at Shandong Provincial Hospital Affiliated to Shandong University from April 2009 to June 2013. Seventy-six cases with enlarged lesions surrounded with peripheral vascularity were allocated to group A and underwent EBUS-TBNA examination. The other 327 cases without peripheral vascularity were allocated to group B and underwent TBNA. Fifty-four of the 62 patients with previous TBNA (group B) negative results consequently underwent EBUS-TBNA were allocated to group C. The association between pathologic examinations and positive rate were analyzed.
Results: Seventy-one cases in group A (93.4%) had a final diagnosis, of which 57 were diagnosed as malignant lesions and 14 as benign lesions. Two hundred and sixty-five cases in group B (81.0%) had a final diagnosis, of which 232 were malignant lesions and 33 benign lesions. Forty-nine cases (90.7%) in group C had a final diagnosis, of which 42 were malignant lesions and 7 benign lesions. The difference between group A and B was significant (χ(2) = 6.639, P = 0.010).
Conclusions: In conventional TBNA examination negative cases, a following EBUS-TBNA examination is necessary and has a satisfactory diagnostic efficacy.