|Table of Contents|

Differential diagnosis of benign and malignant mediastinal enlarged lymph nodes under endocopic ultrasonography during EBUS-TBNA

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2020 03
Page:
473-477
Research Field:
Publishing date:

Info

Title:
Differential diagnosis of benign and malignant mediastinal enlarged lymph nodes under endocopic ultrasonography during EBUS-TBNA
Author(s):
Zhao Congxuan; Yu Tao; Wang Wenhui; Ye Dongman; Zhou Hongyan
Department of Diagnostic Ultrasound，Cancer Hospital of China Medical University，Liaoning Cancer Hospital ＆ Institute，Liaoning Shenyang 110042，China.
Keywords:
endobronchial ultrasound-guided needle aspiration biopsy（EBUS-TBNA）; mediastinum; enlarged lymph node; ultrasound; sonographic features
PACS:
R734.5
DOI:
10.3969/j.issn.1672-4992.2020.03.028
Abstract:
Objective：To analyze the characteristics of sonographic features of enlarged mediastinal lymph nodes during endobronchial ultrasound-guided transbronchial needle aspiration （EBUS-TBNA），and to explore the value of endoscopic ultrasonography in the differential diagnosis of benign and malignant mediastinal lymph nodes during EBUS-TBNA，so as to improve the biopsy rate of malignant mediastinal lymph nodes during EBUS-TBNA.Methods：EBUS-TBNA patients from October 2014 to November 2018 were retrospectively analyzed.The following sonographic features during EBUS-TBNA were used to predict the lymph nodes：echogenicity(homogeneous or heterogeneous，long axis length，short axis length，aspect ratio，morphology，margin，presence or absence of normal hilus，and blood flow classification.The results of sonographic examination were compared with the final pathological results or clinical follow-up results.SPSS 20.0 software was used for statistical analysis，and logistic regression analysis was used to evaluate the correlation between benign and malignant lymph nodes and sonographic characteristics during EBUS-TBNA.P<0.05 was used as the standard to determine that the difference was statistically significant.Results：In a retrospective analysis of 227 lymph nodes in 130 patients with mediastinal lymphadenopathy，67.4% of the enlarged lymph nodes were confirmed as malignant metastases.Logistic regression analysis showed that the echogenicity，the long and short axis length and absence of normal hilus were independent predictors of the diagnosis of malignant lymph nodes.Conclusion：Mediastinal malignant lymph node has certain sonographic characteristics，and the detection rate of EBUS-TBNA for mediastinal lymph node metastasis can be improved through these ultrasonic characteristics.

References:

［1］Ettinger DS，Wood DE，Akerley W，et al.Non-small cell lung cancer，version 6.2015［J］.Journal of the National Comprehensive Cancer Network，2015，13(5)：515-524.
［2］Fujiwara T，Yasufuku K，Nakajima T，et al.The utility of sonographic features during endobronchial ultrasound-guided transbronchial needle aspiration for lymph node staging in patients with lung cancer：a standard endobronchial ultrasound image classification system［J］.Chest，2010，138(3)：641-647.
［3］Lin CK，Chang LY，Yu KL，et al.Differentiating metastatic lymph nodes in lung cancer patients based on endobronchial ultrasonography features［J］.Medical Ultrasonography，2018，20(2)：154-158.
［4］Wang Y，Dan HJ，Fan JH，et al.Evaluation of the correlation between colour power doppler flow imaging and vascular endothelial growth factor in breast cancer［J］.Journal of International Medical Research，2010，38(3)：1077-1083.
［5］LI Xiaoyan，ZHAO Ziwen，ZHONG Weinong，et al.Endobronchial ultrasound-guided transbronchial needle aspiration EBUS-TBNA vs conventional transbronchial needle aspiration cTBNA in the diagnosis of mediastinal and hilar lymph nodes［J］.Guangzhou Medical Journal，2016，47(3)：22-25.［李晓岩，赵子文，钟维农，等.cTBNA与EBUS-TBNA在肺门及纵隔淋巴结肿大疾病诊断中的比较［J］.广州医药，2016，47(3)：22-25.］
［6］Colella S.Endoscopic ultrasound in the diagnosis and staging of lung cancer［J］.Endoscopic Ultrasound，2014，3(4)：205-212.
［7］Wang Lei，Wu Weihua，Hu Yunqian，et al.Sonographic features of endobronchial ultrasonography predict intrathoracic lymph node metastasis in lung cancer patients［J］.Annals of Thoracic Surgery，2015，100(4)：1203-1210.
［8］Folkman，Judah.Angiogenesis in cancer，vascular，rheumatoid and other disease［J］.Nature Med，1995，1(1)：27-30.
［9］Wojtukiewicz MZ，Sierko E，Klementt P，et al.The hemostatic system and angiogenesis in malignancy［J］.Neoplasia，2001，3(5)：371-384.
［10］Gerald SB，Hongbin J，Georg K，et al.Predicting malignancy in mediastinal lymph nodes by endobronchial ultrasound：A new ultrasound scoring system［J］.Respirology，2012，17(8)：1190-1198.
［11］He Haiyan，Lv Xuedong，Ma Hang，et al.Value of endobronchial ultrasound elastography in the diagnosis of mediastinal and hilar lymph node metastasis in lung cancer［J］.Journal of Central South University(Medical Sciences)，2016，41(1)：30-36.
［12］Nakajima T，Shingyoji M，Anayama T，et al.Spectrum analysis of endobronchial ultrasound radiofrequency of lymph nodes in patients with lung cancer［J］.Chest，2016，149(6)：1393-1399.
［13］Xiang Qing，Wan Tao，Hu Qianfang，et al.Value of C-ROSE during EBUS-TBNA to obtain the tissue sample in the diagnosis of lung cancer［J］.Chinese Journal of Lung Cancer，2018，21(11)：35-42.
［14］Luisella R，Francesca F，Francesca M，et al.Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)-from morphology to molecular testing［J］.Journal of Thoracic Disease，2017，9(S5)：S395-S404.

Memo

Memo:
National Natural Science Foundation of China(No.81872363);国家自然科学基金资助项目面上项目（编号：81872363）
Last Update: 1900-01-01