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Less-Invasive Lung Cancer Staging Methods Analyzed

Combination more reliable than any one minimally invasive method in staging lung cancer

TUESDAY, Feb. 5 (HealthDay News) -- Researchers compared three minimally invasive methods, separately and combined, for biopsying suspected metastatic lymph nodes within the mediastinum in patients undergoing a work-up for lung cancer diagnosis and staging, and found a combination of methods more reliable than any one method. The study results are published in the Feb. 6 issue of the Journal of the American Medical Association.

Michael B. Wallace, M.D., from the Mayo Clinic in Jacksonville, Fla., and his colleagues compared transbronchial needle aspiration (TBNA), endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA), and transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The researchers carried out all three biopsy methods on 138 patients with suspected lung cancer and suspicious mediastinal lymph nodes, as diagnosed with computed tomography and positron emission tomography scanning.

EBUS-FNA was more sensitive than TBNA, identifying 29 out of 42 malignant lymph nodes (69 percent sensitivity versus 36 percent for TBNA). But EUS-FNA plus EBUS-FNA had 93 percent sensitivity, detecting 39 out of 42 malignant lymph nodes. The combination of these two methods also had a good negative predictive value, accurately assessing 97 percent of true negative results.

Wallace and colleagues note, "In all anatomical subgroups, EUS plus EBUS performed better than any procedure alone. Thus, training and organizational infrastructure to provide high-quality EUS plus EBUS services is critical."

Wallace has financial relationships with Olympus Corp., Fujinon, and Cook Co.

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