Predicting Malignant Lymph Nodes Using a Novel Scoring System Based on Multi-Endobronchial Ultrasound Features

被引:8
作者
Morishita, Momoko [1 ,2 ,3 ]
Uchimura, Keigo [1 ]
Furuse, Hideaki [1 ]
Imabayashi, Tatsuya [1 ]
Tsuchida, Takaaki [1 ]
Matsumoto, Yuji [1 ,2 ]
机构
[1] Natl Canc Ctr, Resp Endoscopy Div, Dept Endoscopy, Chuo Ku, 5-1-1 Tsukiji, Tokyo 1040045, Japan
[2] Natl Canc Ctr, Dept Thorac Oncol, Chuo Ku, 5-1-1 Tsukiji, Tokyo 1040045, Japan
[3] Natl Ctr Global Hlth & Med, Dept Resp Med, Shinjuku Ku, 1-21-1 Toyama, Tokyo 1628655, Japan
关键词
bronchoscopy; cytology; endobronchial ultrasound; transbronchial needle aspiration; histology; lung cancer; elastography; TRANSBRONCHIAL NEEDLE ASPIRATION; LUNG-CANCER; SONOGRAPHIC FEATURES; STRAIN ELASTOGRAPHY; NODAL METASTASIS; DIAGNOSIS;
D O I
10.3390/cancers14215355
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Simple Summary Endobronchial ultrasound (EBUS) features help differentiate between benign and malignant lymph nodes (MLNs) during transbronchial needle aspiration (TBNA). B-, power/color Doppler, and elastography modes are used during EBUS-TBNA. However, only few studies have assessed them simultaneously. This study evaluated multi-EBUS features (B-, power/color Doppler, and elastography modes) and established a novel scoring system. Multivariable analysis revealed that short axis (>1 cm), heterogeneous echogenicity, absence of central hilar structure, presence of coagulation necrosis sign, and blue-dominant elastographic images were independent predictors of MLNs. At three or more EBUS features predicting MLNs, our scoring system had high sensitivity and specificity (77.9 and 91.8%, respectively). The area under the receiver operating curve (AUC) was 0.894 (95% confidence interval (CI): 0.868-0.920), higher than that of B-mode features alone (AUC: 0.840 (95% CI: 0.807-0.873)). Our novel scoring system could predict MLNs more accurately than B-mode features alone. Endobronchial ultrasound (EBUS) features with B-, power/color Doppler, and elastography modes help differentiate between benign and malignant lymph nodes (MLNs) during transbronchial needle aspiration (TBNA); however, only few studies have assessed them simultaneously. We evaluated the diagnostic accuracy of each EBUS feature and aimed to establish a scoring system to predict MLNs. EBUS features of consecutive patients and final diagnosis per lymph node (LN) were examined retrospectively. In total, 594 LNs from 301 patients were analyzed. Univariable analyses revealed that EBUS features, except for round shape, could differentiate MLNs from benign LNs. Multivariable analysis revealed that short axis (>1 cm), heterogeneous echogenicity, absence of central hilar structure, presence of coagulation necrosis sign, and blue-dominant elastographic images were independent predictors of MLNs. At three or more EBUS features predicting MLNs, our scoring system had high sensitivity (77.9%) and specificity (91.8%). The area under the receiver operating curve (AUC) was 0.894 (95% confidence interval (CI): 0.868-0.920), which was higher than that of B-mode features alone (AUC: 0.840 (95% CI: 0.807-0.873)). The novel scoring system could predict MLNs more accurately than B-mode features alone. Multi-EBUS features may increase EBUS-TBNA efficiency for LN evaluation.
引用
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页数:12
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共 36 条
[1]   Test performance of endobronchial ultrasound and transbronchial needle aspiration biopsy for mediastinal staging in patients with lung cancer: systematic review and meta-analysis [J].
Adams, K. ;
Shah, P. L. ;
Edmonds, L. ;
Lim, E. .
THORAX, 2009, 64 (09) :757-762
[2]   Impact of 18F-FDG PET/CT, CT and EBUS/TBNA on preoperative mediastinal nodal staging of NSCLC [J].
Al-Ibraheem, Akram ;
Hirmas, Nader ;
Fanti, Stefano ;
Paez, Diana ;
Abuhijla, Fawzi ;
Al-Rimawi, Dalia ;
Al-Rasheed, Ula ;
Abdeljalil, Riad ;
Hawari, Feras ;
Alrabi, Kamal ;
Mansour, Asem .
BMC MEDICAL IMAGING, 2021, 21 (01)
[3]   The sonographic features of malignant mediastinal lymph nodes and a proposal for an algorithmic approach for sampling during endobronchial ultrasound [J].
Alici, Ibrahim Onur ;
Demirci, Nilgun Yilmaz ;
Yilmaz, Aydin ;
Karakaya, Jale ;
Ozaydin, Esra .
CLINICAL RESPIRATORY JOURNAL, 2016, 10 (05) :606-613
[4]   Endobronchial Ultrasound Elastography Differentiates Intrathoracic Lymph Nodes: A Meta-Analysis [J].
Chen, Ye-Feng ;
Mao, Xiao-Wei ;
Zhang, Yu-Jun ;
Zhang, Chun-Yi ;
Yu, Yue-Fang ;
Qin, E. ;
Chen, Xing ;
Shen, Ju-Xin .
ANNALS OF THORACIC SURGERY, 2018, 106 (04) :1251-1257
[5]   An Artificial Intelligence Algorithm to Predict Nodal Metastasis in Lung Cancer [J].
Churchill, Isabella F. ;
Gatti, Anthony A. ;
Hylton, Danielle A. ;
Sullivan, Kerrie A. ;
Patel, Yogita S. ;
Leontiadis, Grigorious, I ;
Farrokhyar, Forough ;
Hanna, Wael C. .
ANNALS OF THORACIC SURGERY, 2022, 114 (01) :248-256
[6]   COMPARING THE AREAS UNDER 2 OR MORE CORRELATED RECEIVER OPERATING CHARACTERISTIC CURVES - A NONPARAMETRIC APPROACH [J].
DELONG, ER ;
DELONG, DM ;
CLARKEPEARSON, DI .
BIOMETRICS, 1988, 44 (03) :837-845
[7]   Comparison of specimen adequacy and diagnostic accuracy of a 25-gauge and 22-gauge needle in endobronchial ultrasound-guided transbronchial needle aspiration [J].
Di Felice, Christopher ;
Young, Benjamin ;
Matta, Maroun .
JOURNAL OF THORACIC DISEASE, 2019, 11 (08) :3642-3648
[8]   Nodal Staging in Lung Cancer A Risk Stratification Model for Lymph Nodes Classified as Negative by EBUS-TBNA [J].
Evison, Matthew ;
Morris, Julie ;
Martin, Julie ;
Shah, Rajesh ;
Barber, Philip V. ;
Booton, Richard ;
Crosbie, Philip A. J. .
JOURNAL OF THORACIC ONCOLOGY, 2015, 10 (01) :126-133
[9]   The combination of endobronchial elastography and sonographic findings during endobronchial ultrasound-guided transbronchial needle aspiration for predicting nodal metastasis [J].
Fujiwara, Taiki ;
Nakajima, Takahiro ;
Inage, Terunaga ;
Sata, Yuki ;
Sakairi, Yuichi ;
Tamura, Hajime ;
Wada, Hironobu ;
Suzuki, Hidemi ;
Chiyo, Masako ;
Yoshino, Ichiro .
THORACIC CANCER, 2019, 10 (10) :2000-2005
[10]   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].
Fujiwara, Taiki ;
Yasufuku, Kazuhiro ;
Nakajima, Takahiro ;
Chiyo, Masako ;
Yoshida, Shigetoshi ;
Suzuki, Makoto ;
Shibuya, Kiyoshi ;
Hiroshima, Kenzo ;
Nakatani, Yukio ;
Yoshino, Ichiro .
CHEST, 2010, 138 (03) :641-647