Added value of EUS-B-FNA to bronchoscopy and EBUS-TBNA in diagnosing and staging of lung cancer

被引:2
|
作者
Issa, Mohammad A. [1 ,10 ]
Clementsen, Paul F. [1 ,2 ]
Laursen, Christian B. [3 ,4 ]
Christiansen, Ida S. [1 ,5 ]
Crombag, Laurence [6 ]
Vilmann, Peter [7 ,8 ]
Bodtger, Uffe [1 ,9 ]
机构
[1] Zealand Univ Hosp, Dept Resp Med, Resp Res Unit PLUZ, Naestved, Denmark
[2] Rigshosp, Copenhagen Acad Med Educ & Simulat CAMES, Copenhagen, Denmark
[3] Odense Univ Hosp, Odense, Denmark
[4] Univ Southern Denmark, Esbjerg, Denmark
[5] Rigshosp, Dept Pathol, Copenhagen, Denmark
[6] Univ Amsterdam, Univ Med Ctr, Dept Resp Med, Amsterdam, Netherlands
[7] Copenhagen Univ Hosp, Gastro Unit, Herlev, Denmark
[8] Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark
[9] Univ Southern Denmark, Inst Reg Hlth Res, Odense, Denmark
[10] Zealand Univ Hosp Naestved, Dept Resp Med, 61 Ringstedgade, DK-4700 Naestved, Denmark
来源
EUROPEAN CLINICAL RESPIRATORY JOURNAL | 2024年 / 11卷 / 01期
关键词
Lung cancer; diagnosis; staging; EUS-B; EBUS; bronchoscopy; FINE-NEEDLE-ASPIRATION; ULTRASOUND-GUIDED BIOPSY; ENDOSCOPIC ULTRASOUND; ENDOBRONCHIAL ULTRASOUND; ESOPHAGEAL ENDOSONOGRAPHY; ADRENAL MASSES; MEDIASTINOSCOPY; ULTRASONOGRAPHY; METASTASIS; MANAGEMENT;
D O I
10.1080/20018525.2024.2362995
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
BackgroundBronchoscopy and EBUS are standard procedures in lung cancer work-up but have low diagnostic yield in lesions outside the central airways and hilar/mediastinal lymph nodes. Growing evidence on introducing the EBUS endoscope into the oesophagus (EUS-B) in the same session as bronchoscopy/EBUS gives access to new anatomical areas that can be safely biopsied.ObjectiveTo summarize the current evidence of the added value of EUS-B-FNA to bronchoscopy and EBUS-TBNA in lung cancer work-up.MethodsA narrative review.ResultsFew randomized trials or prospective studies are available. Prospective studies show that add-on EUS-B-FNA increases diagnostic yield when sampling abnormal mediastinal lymph nodes, para-oesophageal lung and left adrenal gland. A large retrospective series on EUS-B-FNA from retroperitoneal lymph nodes suggests high diagnostic yield without safety concerns, as do casuistic reports on EUS-B-FNA from mediastinal pleural thickening, pancreatic lesions, ascites fluid and pericardial effusions. No study has systematically assessed both diagnostic yield, safety, patient reported outcomes, adverse events and costs.ConclusionThe diagnostic value of add-on EUS-B to standard bronchoscopy and EBUS in lung cancer work-up appears very promising without safety concerns, giving the pulmonologist access to a variety of sites out of reach with other minimally invasive techniques. Little is known on patient-reported outcomes and costs. Future and prospective research should focus on effectiveness aspects to clarify whether overall benefits of add-on EUS-B sufficiently exceed overall downsides.
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页数:12
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