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Transbronchial Needle Aspiration in the Study of Mediastinal Lymph Nodes: Yield and Cost-Effectiveness
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class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Transbronchial Needle Aspiration in the Study of Mediastinal Lymph Nodes: Yield and Cost-Effectiveness" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "290" "paginaFinal" => "294" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Pilar Martínez-Olondris, María Molina-Molina, Antoni Xaubet, Ramón María Marrades, Patricio Luburich, José Ramírez, Antoni Torres, Carlos Agustí" "autores" => array:8 [ 0 => array:3 [ "nombre" => "Pilar" "apellidos" => "Martínez-Olondris" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "María" "apellidos" => "Molina-Molina" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "Antoni" "apellidos" => "Xaubet" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "Ramón María" "apellidos" => "Marrades" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "Patricio" "apellidos" => "Luburich" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 5 => array:3 [ "nombre" => "José" "apellidos" => "Ramírez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 6 => array:3 [ "nombre" => "Antoni" "apellidos" => "Torres" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 7 => array:4 [ "nombre" => "Carlos" "apellidos" => "Agustí" "email" => array:1 [ 0 => "cagusti@clinic.ub.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servei de Pneumologia, Institut Clínic del Tòrax, IDIBAPS, Hospital Clínic, CIBER Enfermedades Respiratorias, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servei de Radiodiagnòstic, Hospital Clínic, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servei d'Anatomia Patològica, Hospital Clínic, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence:Dr C. AgustíServei de Pneumologia, Hospital Clínic Villarroel, 17008036 Barcelona, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-06-15" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155268" "palabras" => array:4 [ 0 => "Lung cancer" 1 => "Staging" 2 => "Mediastinal lymph nodes" 3 => "Fiberoptic bronchoscopy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155269" "palabras" => array:4 [ 0 => "Cáncer de pulmón" 1 => "Estadificación" 2 => "Adenopatíasmediastínicas" 3 => "Fibrobroncoscopia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The role of different techniques formediastinal staging in patients with suspected lung cancer isa subject of debate. The aim of this study was to analyze the diagnostic yield and cost-effectiveness of transbronchialneedle aspiration in the mediastinal staging of lung cancerin patients being evaluated in a tertiary hospital.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">This was a retrospective, observational study of the results of transbronchial needleaspiration in patients with suspected lung cancer andmediastinal lymph node involvement. A cost-effectivenessanalysis of the systematic use of this technique was also performed.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">One-hundred ninety-four patients (85% men,15% women) were evaluated. The diagnosis of lung cancerwas confirmed in 157 (81%). Cytology samples obtained bytransbronchial needle aspiration were adequate in 147 (76%)of the 194 cases. When only the adequate samples wereincluded in the analysis, transbronchial needle aspirationshowed a sensitivity of 88%, specificity of 100%, positivepredictive value of 100%, negative predictive value of 64%, and efficiency of 90%. Mediastinoscopy was avoided in 44 (34%) of the 127 patients with localized non-small celllung cancer, with an estimated saving of €119 456.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Transbronchial needle aspiration has a highdiagnostic yield and obviates the need for mediastinoscopy ina significant percentage of cases. This finding is of diagnosticand economic significance.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Existe controversia sobre el papel de las dife-rentes técnicas diagnósticas en la estadificación del mediasti-no en pacientes con sospecha de cáncer de pulmón. El obje-tivo del estudio ha sido analizar la rentabilidad diagnósticay el coste-beneficio de la punción transbronquial aspirativa(PTA) en la estadificación mediastínica del cáncer de pul-món, en pacientes evaluados en un hospital de tercer nivel.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio obser-vacional retrospectivo, en el que se han analizado los resul-tados de las PTA practicadas a pacientes con sospecha decáncer de pulmón y adenopatías mediastínicas patológicas. También se ha evaluado el coste-beneficio de la aplicaciónsistemática de esta técnica.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se evaluó a 194 pacientes (un 85% varonesy un 15% mujeres), en 157 de los cuales (81%) se confirmóel diagnóstico de cáncer de pulmón. La muestra citológicaque se obtuvo de la PTA fue adecuada en 147 de los 194 ca-sos (76%). Cuando se analizaron las muestras adecuadas, lasensibilidad de la PTA fue del 88%, la especificidad del100%, el valor predictivo positivo del 100%, el valor predic-tivo negativo del 64% y el valor global del 90%. En 44 de los127 casos (34%) con cáncer de pulmón no microcítico locali-zado se evitó la realización de una mediastinoscopia, lo querepresentó un ahorro económico estimado de 119.456 €.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La PTA es una técnica con una elevadarentabilidad diagnóstica que puede evitar la realización deuna mediastinoscopia en un porcentaje significativo de pa-cientes, con las consiguientes implicaciones terapéuticas yeconómicas que ello conlleva.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This study was partially financed by FUCAP-05 (Catalan Pneumology Foundation grant).</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Normativa actualizada sobre diagnóstico y estadificación del carcinoma broncogénico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R Ramí" 1 => "JL Duque" 2 => "JR Hernández" 3 => "J Sánchez de Cos" 4 => "Grupo de trabajo SEPAR" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "1998" "volumen" => "34" "paginaInicial" => "437" "paginaFinal" => "452" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9842457" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronchogenic carcinoma; analysis of staging in the mediastinum with CT by correlative lymph node mapping and sampling" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "TC McLoud" 1 => "PM Bourgouin" 2 => "RW Greenberg" 3 => "JP Kosiuk" 4 => "PA Templeton" 5 => "JO Shepard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiology.182.2.1732943" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "1992" "volumen" => "182" "paginaInicial" => "319" "paginaFinal" => "323" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1732943" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meta-analysis of computed tomography for staging non-small cell lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "RS Fontana" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/141.5_Pt_1.1093" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1990" "volumen" => "141" "paginaInicial" => "1093" "paginaFinal" => "1094" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2160210" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prognostic significance of preoperative assessment of mediastinal lymph nodes in patients with lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "GB Ratto" 1 => "C Mereu" 2 => "G Motta" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1988" "volumen" => "93" "paginaInicial" => "807" "paginaFinal" => "813" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3349839" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Can computed tomography of the chest stage lung cancer? 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 11 | 14 |
| 2024 October | 34 | 17 | 51 |
| 2024 September | 37 | 12 | 49 |
| 2024 August | 58 | 26 | 84 |
| 2024 July | 28 | 22 | 50 |
| 2024 June | 42 | 27 | 69 |
| 2024 May | 45 | 33 | 78 |
| 2024 April | 19 | 23 | 42 |
| 2024 March | 23 | 16 | 39 |
| 2024 February | 26 | 25 | 51 |
| 2023 March | 2 | 2 | 4 |
| 2023 February | 21 | 15 | 36 |
| 2023 January | 16 | 28 | 44 |
| 2022 December | 19 | 33 | 52 |
| 2022 November | 24 | 17 | 41 |
| 2022 October | 18 | 32 | 50 |
| 2022 September | 49 | 19 | 68 |
| 2022 August | 52 | 26 | 78 |
| 2022 July | 49 | 43 | 92 |
| 2022 June | 22 | 30 | 52 |
| 2022 May | 22 | 27 | 49 |
| 2022 April | 17 | 30 | 47 |
| 2022 March | 17 | 39 | 56 |
| 2022 February | 20 | 28 | 48 |
| 2022 January | 19 | 43 | 62 |
| 2021 December | 17 | 42 | 59 |
| 2021 November | 16 | 42 | 58 |
| 2021 October | 47 | 58 | 105 |
| 2021 September | 25 | 59 | 84 |
| 2021 August | 28 | 35 | 63 |
| 2021 July | 36 | 19 | 55 |
| 2021 June | 16 | 33 | 49 |
| 2021 May | 19 | 24 | 43 |
| 2021 April | 35 | 36 | 71 |
| 2021 March | 21 | 23 | 44 |
| 2021 February | 17 | 16 | 33 |
| 2021 January | 11 | 12 | 23 |
| 2020 December | 14 | 19 | 33 |
| 2020 November | 11 | 16 | 27 |
| 2020 October | 19 | 5 | 24 |
| 2020 September | 9 | 5 | 14 |
| 2020 August | 9 | 11 | 20 |
| 2020 July | 15 | 18 | 33 |
| 2020 June | 16 | 0 | 16 |
| 2020 May | 10 | 13 | 23 |
| 2020 April | 18 | 22 | 40 |
| 2020 March | 16 | 11 | 27 |
| 2020 February | 18 | 14 | 32 |
| 2020 January | 32 | 16 | 48 |
| 2019 December | 19 | 12 | 31 |
| 2019 November | 18 | 13 | 31 |
| 2019 October | 9 | 6 | 15 |
| 2019 September | 9 | 14 | 23 |
| 2019 August | 17 | 13 | 30 |
| 2019 July | 18 | 14 | 32 |
| 2019 June | 14 | 15 | 29 |
| 2019 May | 14 | 23 | 37 |
| 2019 April | 15 | 19 | 34 |
| 2019 March | 13 | 20 | 33 |
| 2019 February | 17 | 14 | 31 |
| 2019 January | 10 | 3 | 13 |
| 2018 December | 13 | 13 | 26 |
| 2018 November | 38 | 12 | 50 |
| 2018 October | 25 | 18 | 43 |
| 2018 September | 19 | 15 | 34 |
| 2018 May | 6 | 0 | 6 |
| 2018 April | 13 | 6 | 19 |
| 2018 March | 11 | 4 | 15 |
| 2018 February | 8 | 4 | 12 |
| 2018 January | 7 | 7 | 14 |
| 2017 December | 7 | 3 | 10 |
| 2017 November | 6 | 7 | 13 |
| 2017 October | 4 | 6 | 10 |
| 2017 September | 5 | 9 | 14 |
| 2017 August | 8 | 6 | 14 |
| 2017 July | 15 | 8 | 23 |
| 2017 June | 10 | 11 | 21 |
| 2017 May | 5 | 4 | 9 |
| 2017 April | 1 | 3 | 4 |
| 2017 March | 6 | 7 | 13 |
| 2017 February | 6 | 5 | 11 |
| 2017 January | 2 | 3 | 5 |
| 2016 December | 7 | 7 | 14 |
| 2016 November | 15 | 4 | 19 |
| 2016 October | 14 | 10 | 24 |
| 2016 September | 12 | 5 | 17 |
| 2016 August | 15 | 3 | 18 |
| 2016 July | 16 | 5 | 21 |
| 2016 April | 1 | 0 | 1 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 40 | 8 | 48 |
| 2015 September | 33 | 6 | 39 |
| 2015 August | 46 | 10 | 56 |
| 2015 July | 37 | 4 | 41 |
| 2015 June | 27 | 2 | 29 |
| 2015 May | 37 | 7 | 44 |
| 2015 April | 27 | 6 | 33 |
| 2015 March | 33 | 8 | 41 |
| 2015 February | 22 | 3 | 25 |
| 2015 January | 18 | 3 | 21 |
| 2014 December | 21 | 5 | 26 |
| 2014 November | 31 | 6 | 37 |
| 2014 October | 36 | 10 | 46 |
| 2014 September | 37 | 9 | 46 |
| 2014 August | 33 | 11 | 44 |
| 2014 July | 31 | 8 | 39 |
| 2014 June | 50 | 11 | 61 |
| 2014 May | 50 | 8 | 58 |
| 2014 April | 52 | 9 | 61 |
| 2014 March | 45 | 9 | 54 |
| 2014 February | 44 | 7 | 51 |
| 2014 January | 61 | 9 | 70 |
| 2013 December | 41 | 11 | 52 |
| 2013 November | 36 | 6 | 42 |
| 2013 October | 40 | 5 | 45 |
| 2013 September | 36 | 8 | 44 |
| 2013 August | 48 | 2 | 50 |
| 2013 July | 53 | 9 | 62 |
| 2013 June | 37 | 8 | 45 |
| 2013 May | 41 | 8 | 49 |
| 2013 April | 24 | 2 | 26 |
| 2013 March | 9 | 2 | 11 |
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