Original Articles
Transbronchial Needle Aspiration of Diseased Mediastinal Lymph Nodes: Predictors of Positive Findings
A. Fernández-Villara,
, F. Iglesiasb, M. Mosteiroa, D. Corbachob, A. Gonzálezc, P. Blancoa, J. Paz-Esqueted, R. Bandrésa, L. Piñeiroa
Corresponding author
jfv01po@saludalia.com
Correspondence: Dr. A. Fernández-Villar. Joaquín Costa, 60, 6.° C. 36004 Pontevedra. España
Correspondence: Dr. A. Fernández-Villar. Joaquín Costa, 60, 6.° C. 36004 Pontevedra. España
a Servicio de Neumología, Hospital Xeral-Cíes, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
b Sección de Neumología, Clínica POVISA, Vigo, Pontevedra, Spain
c Servicio de Anatomía Patológica, Hospital Xeral-Cíes, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
d Servicio de Medicina Preventiva, Complexo Hospitalario de Pontevedra, Pontevedra, Spain
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Fernández-Villar. Joaquín Costa, 60, 6.° C. 36004 Pontevedra. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-07-29" "fechaAceptado" => "2004-11-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec154133" "palabras" => array:5 [ 0 => "Transbronchial needle aspiration" 1 => "Lymph nodes: mediastinal" 2 => "diseased" 3 => "Bronchoscope" 4 => "flexible" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154134" "palabras" => array:3 [ 0 => "Punción transtraqueal" 1 => "Adenopatías mediastínicas" 2 => "Broncoscopio flexible" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">TO assess the factors that may determine the effectiveness of transbronchial needle aspiration through a flexible bronchoscope in the diagnosis of diseased mediastinal lymph nodes in patients with lung or extrapulmonary tumors.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Prospective study carried out at 2 hospitals between 1998 and 2004 that included all transbronchial needle aspirations performed on patients who had diseased mediastinal lymph nodes larger than 10 mm and nonlymphoid neoplasms. Univariate and multivariate analysis of the diagnostic results of transbronchial needle aspiration were performed according to the type and location of the primary neoplasm and the lymph node station biopsied, the diameter of the affected node, endoscopic findings, and the results of other bronchoscopic techniques.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The study evaluated the transbronchial needle aspiration of 230 lymph node stations in 207 patients. Histologic examination revealed 151 cases (72.9%) of non-small cell lung cancer, 42 cases (20.3%) of small cell lung cancer, and 14 cases (6.8%) of extrapulmonary cancer. The best predictors of obtaining a diagnostic sample were a diameter of the diseased node greater than 20 mm (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.2-4.7; <span class="elsevierStyleItalic">P</span> = .01) and a histologic diagnosis of small cell lung cancer (OR, 2.7; 95% CI, 0.9-8.2; <span class="elsevierStyleItalic">P</span> = .07).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The size of the diseased node and the tumor type are the best predictors of obtaining a diagnostic sample with transbronchial needle aspiration of diseased mediastinal lymph nodes in patients with lung or extrapulmonary tumors.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar los factores que pueden influir en la efectividad de la punción transtraqueal (PTT) a través del broncoscopio flexible en el diagnóstico de adenopatías mediastínicas en pacientes con neoplasias pulmonares o extra-pulmonares.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo realizado entre 1998 y 2004 en el que se incluyeron todas las PTT realizadas a pacientes con adenopatías mediastínicas superiores a 10 mm y neoplasias no linfoides de 2 centros hospitalarios. Se realizó un análisis univariado y multivariado entre los resultados diagnósticos de la PTT según el tipo y la localización de la neoplasia primaria y la estación ganglionar analizada, el diámetro de la adenopatía, los hallazgos endoscópicos y los resultados de otras técnicas broncoscópicas.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyeron en el estudio 230 PTT de esta-ciones ganglionares distintas de 207 pacientes. Las estirpes histológicas fueron en 151 casos (72,9%) carcinomas no mi-crocíticos pulmonares, en 42 (20,3%) carcinomas microcíti-cos y en 14 (6,8%) carcinomas extrapulmonares. Las variables que mejor predijeron la obtención de muestras diagnósticas fueron el diámetro de la adenopatía superior a 20 mm (<span class="elsevierStyleItalic">odds ratio</span> [OR] = 2,4; intervalo de confianza [IC] del 95%, 1,2-4,7; p = 0,01) y que el tipo de neoplasia fuera un carcinoma pulmonar microcítico (OR = 2,7; IC del 95%, 0,9-8,2; p = 0,07).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El tamaño de la adenopatía y el tipo de neoplasia son los factores que mejor predicen la obtención de muestras adecuadas en la PTT de adenopatías mediastínicas en pacientes con neoplasias pulmonares o extrapulmonares.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Normativa 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 1 | 3 |
| 2024 October | 30 | 17 | 47 |
| 2024 September | 31 | 17 | 48 |
| 2024 August | 51 | 42 | 93 |
| 2024 July | 25 | 18 | 43 |
| 2024 June | 45 | 28 | 73 |
| 2024 May | 50 | 28 | 78 |
| 2024 April | 16 | 25 | 41 |
| 2024 March | 20 | 13 | 33 |
| 2024 February | 20 | 23 | 43 |
| 2023 March | 5 | 6 | 11 |
| 2023 February | 20 | 16 | 36 |
| 2023 January | 19 | 27 | 46 |
| 2022 December | 16 | 27 | 43 |
| 2022 November | 23 | 26 | 49 |
| 2022 October | 26 | 26 | 52 |
| 2022 September | 19 | 27 | 46 |
| 2022 August | 18 | 37 | 55 |
| 2022 July | 19 | 33 | 52 |
| 2022 June | 20 | 31 | 51 |
| 2022 May | 17 | 33 | 50 |
| 2022 April | 20 | 35 | 55 |
| 2022 March | 17 | 32 | 49 |
| 2022 February | 15 | 24 | 39 |
| 2022 January | 44 | 28 | 72 |
| 2021 December | 25 | 39 | 64 |
| 2021 November | 22 | 44 | 66 |
| 2021 October | 33 | 48 | 81 |
| 2021 September | 14 | 48 | 62 |
| 2021 August | 24 | 31 | 55 |
| 2021 July | 18 | 32 | 50 |
| 2021 June | 20 | 46 | 66 |
| 2021 May | 16 | 24 | 40 |
| 2021 April | 29 | 34 | 63 |
| 2021 March | 29 | 15 | 44 |
| 2021 February | 9 | 16 | 25 |
| 2021 January | 5 | 8 | 13 |
| 2020 December | 14 | 13 | 27 |
| 2020 November | 8 | 14 | 22 |
| 2020 October | 12 | 11 | 23 |
| 2020 September | 9 | 3 | 12 |
| 2020 August | 7 | 14 | 21 |
| 2020 July | 13 | 22 | 35 |
| 2020 June | 10 | 7 | 17 |
| 2020 May | 11 | 14 | 25 |
| 2020 April | 18 | 15 | 33 |
| 2020 March | 7 | 14 | 21 |
| 2020 February | 17 | 19 | 36 |
| 2020 January | 18 | 16 | 34 |
| 2019 December | 12 | 19 | 31 |
| 2019 November | 14 | 16 | 30 |
| 2019 October | 12 | 8 | 20 |
| 2019 September | 10 | 6 | 16 |
| 2019 August | 9 | 10 | 19 |
| 2019 July | 12 | 19 | 31 |
| 2019 June | 2 | 14 | 16 |
| 2019 May | 10 | 5 | 15 |
| 2019 April | 25 | 32 | 57 |
| 2019 March | 7 | 19 | 26 |
| 2019 February | 10 | 12 | 22 |
| 2019 January | 9 | 9 | 18 |
| 2018 December | 2 | 14 | 16 |
| 2018 November | 11 | 15 | 26 |
| 2018 October | 14 | 12 | 26 |
| 2018 September | 11 | 11 | 22 |
| 2018 May | 7 | 0 | 7 |
| 2018 April | 3 | 6 | 9 |
| 2018 March | 10 | 1 | 11 |
| 2018 February | 6 | 6 | 12 |
| 2018 January | 4 | 5 | 9 |
| 2017 December | 3 | 7 | 10 |
| 2017 November | 4 | 7 | 11 |
| 2017 October | 6 | 4 | 10 |
| 2017 September | 6 | 6 | 12 |
| 2017 August | 7 | 9 | 16 |
| 2017 July | 3 | 2 | 5 |
| 2017 June | 7 | 11 | 18 |
| 2017 May | 7 | 10 | 17 |
| 2017 April | 2 | 5 | 7 |
| 2017 March | 6 | 3 | 9 |
| 2017 February | 3 | 4 | 7 |
| 2017 January | 2 | 2 | 4 |
| 2016 December | 7 | 8 | 15 |
| 2016 November | 13 | 5 | 18 |
| 2016 October | 6 | 7 | 13 |
| 2016 September | 4 | 7 | 11 |
| 2016 August | 4 | 4 | 8 |
| 2016 July | 1 | 4 | 5 |
| 2016 March | 3 | 0 | 3 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 44 | 6 | 50 |
| 2015 September | 50 | 7 | 57 |
| 2015 August | 44 | 9 | 53 |
| 2015 July | 31 | 15 | 46 |
| 2015 June | 43 | 1 | 44 |
| 2015 May | 41 | 6 | 47 |
| 2015 April | 32 | 11 | 43 |
| 2015 March | 44 | 9 | 53 |
| 2015 February | 44 | 4 | 48 |
| 2015 January | 51 | 3 | 54 |
| 2014 December | 60 | 5 | 65 |
| 2014 November | 43 | 10 | 53 |
| 2014 October | 50 | 5 | 55 |
| 2014 September | 38 | 5 | 43 |
| 2014 August | 38 | 10 | 48 |
| 2014 July | 22 | 6 | 28 |
| 2014 June | 46 | 12 | 58 |
| 2014 May | 39 | 10 | 49 |
| 2014 April | 47 | 3 | 50 |
| 2014 March | 42 | 7 | 49 |
| 2014 February | 27 | 8 | 35 |
| 2014 January | 33 | 10 | 43 |
| 2013 December | 25 | 4 | 29 |
| 2013 November | 33 | 7 | 40 |
| 2013 October | 32 | 5 | 37 |
| 2013 September | 35 | 12 | 47 |
| 2013 August | 31 | 8 | 39 |
| 2013 July | 41 | 14 | 55 |
| 2013 June | 36 | 9 | 45 |
| 2013 May | 34 | 7 | 41 |
| 2013 April | 30 | 6 | 36 |
| 2013 March | 10 | 1 | 11 |
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