Randomized controlled trial to evaluate the utility of suction and inner-stylet of EBUS-TBNA for mediastinal and hilar lymphadenopathy

doi:10.1186/s12890-018-0751-0

科研成果详情

题名	Randomized controlled trial to evaluate the utility of suction and inner-stylet of EBUS-TBNA for mediastinal and hilar lymphadenopathy
作者	Lin, Xiaoxiao 1; Ye, Min1; Li, Yuping1; Ren, Jing 1; Lou, Qiyan 1; Li, Yangyang 2; Jin, Xiaohui3; Wang, Ko-Pen 4; Chen, Chengshui1
发表日期	2018-12-07
发表期刊	BMC PULMONARY MEDICINE 影响因子和分区
语种	英语
原始文献类型	Article
关键词	Endobronchial ultrasound-guided transbronchial needle aspiration Clinical trial Lymphadenopathy Malignant
其他关键词	TRANSBRONCHIAL NEEDLE ASPIRATION ; CELL LUNG-CANCER ; ENDOBRONCHIAL ULTRASOUND ; ENDOSONOGRAPHY ; DIAGNOSIS
摘要	BackgroundThe optimal procedure for maximizing the diagnostic yield and minimizing the procedural complexity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is controversial. We conducted a prospective randomized controlled trial to determine the optimal procedure of EBUS-TBNA for mediastinal and hilar lymphadenopathy, with a particular focus on the roles of the inner-stylet and suction.MethodsConsecutive patients with enlarged mediastinal and hilar lymph nodes (LNs), detected by computed tomography (CT) or positron emission tomography-CT (PET-CT), who underwent EBUS-TBNA were included. Each LN was sampled with three needle passes using suction-stylet, suction-no stylet, and stylet-no suction procedures. The samples were smeared onto glass slides for cytological evaluation. A single, blinded cytopathologist evaluated each set of slides. The primary outcomes were cytological specimen adequacy rate and diagnostic yield of malignant LNs. The secondary outcomes were tissue-core acquisition rate, procedural time, and the amount of bleeding.ResultsThis study evaluated 97 patients with a total of 255 LNs. The final LN diagnosis was benign in 144, malignant in 104, and inadequate in 7 cases. There were no significant differences among the suction-stylet, suction-no stylet, and stylet-no suction groups in specimen adequacy rate (87.1, 88.2, 85.9%, respectively) or diagnostic yield of malignancy (32.2, 31.8, 31.0%, respectively). However, the use of suction was associated with an increase in tissue-core acquisition rate (P<0.001). The no-stylet procedure decreased the average procedural time by 14s (P<0.001). There was no significant difference in the amount of bleeding among the procedures.ConclusionsThe use of suction or non-use of an inner-stylet does not make a significant difference in cytological specimen adequacy or diagnostic yield when performing EBUS-TBNA. While omitting the stylet can simplify the procedure, applying suction can increase the tissue-core acquisition rate. These findings may assist endoscopic physicians in determining the optimal EBUS-TBNA procedure and warrant clinical verification in a future multicentre study.Trial registrationTrial registration: (ChiCTR-IOR-17010616). Retrospective registered date: 12th February, 2017.
资助项目	International Pulmonary Key Laboratory of Zhejiang Province; Interventional Pulmonology Key Laboratory of Wenzhou City; Interventional Pulmonology Innovation Subject of Zhejiang Province; National Nature Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81270313, 81770074, 81570075]; Natural Science Foundation of Zhejiang ProvinceNatural Science Foundation of Zhejiang Province [LZ15H010001]; Science Technology Department Foundation of Zhejiang Province [WKJ-ZJ-1526]; National Key R&D Program of China [2016YFC1304000]
出版者	BMC
出版地	LONDON
ISSN	1471-2466
卷号	18 期号:1 页码:192
DOI	10.1186/s12890-018-0751-0
页数	7
WOS类目	Respiratory System
WOS研究方向	Respiratory System
WOS记录号	WOS:000452753700001
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	30526587
PMC记录号	PMC6286611
SCOPUSEID	2-s2.0-85058020723
通讯作者地址	[Chen, Chengshui]Department of Pulmonary and Critical Care Medicine,First Affiliated Hospital of Wenzhou Medical University,Ouhai District, Wenzhou,China
Scopus学科分类	Pulmonary and Respiratory Medicine
引用统计	被引频次：7[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/17784
专题	第一临床医学院（信息与工程学院）、附属第一医院_内科学_呼吸与危重症医学科附属第一医院基础医学院（机能实验教学中心）_病理学与病理生理学系第一临床医学院（信息与工程学院）、附属第一医院_流行病学_流行病
通讯作者	Chen, Chengshui
作者单位	1.Department of Pulmonary and Critical Care Medicine,First Affiliated Hospital of Wenzhou Medical University,Ouhai District, Wenzhou,China; 2.Department of Pathology,First Affiliated Hospital of Wenzhou Medical University,Ouhai District, Wenzhou,China; 3.Department of Endoscopy,First Affiliated Hospital of Wenzhou Medical University,Ouhai District, Wenzhou,China; 4.Division of Pulmonary and Critical Care Medicine,Johns Hopkins University School of Medicine,Baltimore,United States
第一作者单位	附属第一医院
通讯作者单位	附属第一医院
第一作者的第一单位	附属第一医院
推荐引用方式 GB/T 7714	Lin, Xiaoxiao,Ye, Min,Li, Yuping,et al. Randomized controlled trial to evaluate the utility of suction and inner-stylet of EBUS-TBNA for mediastinal and hilar lymphadenopathy[J]. BMC PULMONARY MEDICINE,2018,18(1):192.
APA	Lin, Xiaoxiao., Ye, Min., Li, Yuping., Ren, Jing., Lou, Qiyan., ... & Chen, Chengshui. (2018). Randomized controlled trial to evaluate the utility of suction and inner-stylet of EBUS-TBNA for mediastinal and hilar lymphadenopathy. BMC PULMONARY MEDICINE, 18(1), 192.
MLA	Lin, Xiaoxiao,et al."Randomized controlled trial to evaluate the utility of suction and inner-stylet of EBUS-TBNA for mediastinal and hilar lymphadenopathy".BMC PULMONARY MEDICINE 18.1(2018):192.