Comparison of the Diagnostic Accuracy of Transbronchial Needle Aspiration for Bronchogenic Carcinoma and Other Malignancies

摘要

This study compares the accuracy of transbronchial needle aspiration (TBNA) for bronchogenic carcinoma with its accuracy in other cancers. A retrospective analysis of 120 consecutive TBNA procedures was performed. All patients who underwent TBNA at Stony Brook University Hospital from March 2000 to March 2002 were included in the analysis. The diagnostic yield of TBNA was 74 of 120 (62%). Of the 120 samples, 67 were true positives; 0, false positives; 31, true negatives; 11, false negatives; and 11 were not able to be determined. Using best-case and worst-case analysis, overall accuracy was 82 to 91%, sensitivity was 75 to 86%, and negative predictive value was 58 to 76%. In the subgroup of patients with bronchogenic carcinoma, accuracy was 86 to 91%, sensitivity was 85 to 90%, and negative predictive value was 42 to 53%. Of the 9 patients with cancer other than lung carcinoma, 5 TBNAs were positive, for an accuracy of 56%, TBNA is highly accurate for diagnosing and for staging the mediastinal lymph nodes in bronchogenic carcinoma, but it is less accurate for cancers other than bronchogenic carcinoma, Given the negative predictive value of TBNA, patients with a high pretest likelihood of malignancy require further workup of nondiagnostic biopsies.