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Vol. 41. Issue 8.
Pages 434-438 (August 2005)
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Vol. 41. Issue 8.
Pages 434-438 (August 2005)
Original Articles
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Transbronchial Needle Aspiration of Diseased Mediastinal Lymph Nodes: Predictors of Positive Findings
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A. Fernández-Villara,
Corresponding author
jfv01po@saludalia.com

Correspondence: Dr. A. Fernández-Villar. Joaquín Costa, 60, 6.° C. 36004 Pontevedra. España
, F. Iglesiasb, M. Mosteiroa, D. Corbachob, A. Gonzálezc, P. Blancoa, J. Paz-Esqueted, R. Bandrésa, L. Piñeiroa
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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Objective

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.

Methods

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.

Results

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; P = .01) and a histologic diagnosis of small cell lung cancer (OR, 2.7; 95% CI, 0.9-8.2; P = .07).

Conclusions

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.

Key Words:
Transbronchial needle aspiration
Lymph nodes: mediastinal
diseased
Bronchoscope
flexible
Objetivo

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.

Métodos

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.

Resultados

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 (odds ratio [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).

Conclusiones

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.

Palabras clave:
Punción transtraqueal
Adenopatías mediastínicas
Broncoscopio flexible
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Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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