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ORIGINAL ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 53-58

Diagnostic accuracy, indications, and negative predictive value of EBUS-TBNA procedure: retrospective observational study from a referral cancer institute


1 Assistant Professor, Department of Pulmonology, Rajiv Gandhi Superspeciality Hospital, New Delhi, India
2 Senior Resident, Department of ENT, Chacha Nehru Bal Chikitsalaya, Delhi, India

Correspondence Address:
Dr. Kunal Luthra
Assistant Professor, Department of Pulmonology, Rajiv Gandhi Superspeciality Hospital, New Delhi 110093
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jacp.jacp_47_19

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Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is minimally invasive procedure for the evaluation of mediastinal mass and lymph nodes. Aim: This study was conducted as an internal audit to determine diagnostic accuracy, false-negative rate of a costly, invasive procedure EBUS-TBNA performed under conscious sedation or deep/general anesthesia. Methods: Forty-nine patients who underwent EBUS-TBNA procedure at our institute were included in this retrospective study. Sensitivity, diagnostic accuracy, and negative predictive values were calculated considering clinical radiological assessment till 6 months as gold standard. Results: Forty-nine patients (27 females and 22 males) with mean age of 47.88 years underwent EBUS-TBNA during a period of 8 months. The most common indication was extrathoracic malignancy metastasis in 26 (53.1%) patients. EBUS-TBNA was performed for diagnosing malignancy lung in 11 patients, granulomatous disease in 8 patients, and mediastinal mass in 4 patients. A total of 74 nodes were sampled in 49 patients. Adequate samples were obtained in 46 patients (93.9%). Diagnostic accuracy was overall 91.8%. There were no procedure-related complications or mortality noted in any patient. Out of 17 negative cases, false negatives were 4, and negative-predictive value was 76.5%. The diagnostic accuracy, sensitivity, and negative predictive value were higher in procedures performed under deep sedation/general anesthesia. Conclusion: Diagnosing extrathoracic malignancy metastasis and malignancy lung are major indications for the EBUS-TBNA procedure at our institute. The diagnostic accuracy overall was 91.8%. The negative-predictive value, diagnostic accuracy, and sensitivity were higher for procedures performed under deep sedation/general anesthesia versus conscious sedation.


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