Clinical evaluation on transbronchial needle aspiration(TBNA) of subcarinal lymph node in lung cancer.

Kang, Yu Ho; Choi, In Seon; Jung, Ik Ju; Park, Jai Hee; Lee, Shin Seok; Lee, Min Su; Kim, Young Cheol; Park, Kyung Ok; Jung, Sang Woo

doi:1993.40.2.177

Tuberc Respir Dis > Volume 40(2); 1993 > Article

Original Article

Tuberculosis and Respiratory Diseases 1993;40(2):177-184.
DOI: https://doi.org/10.4046/trd.1993.40.2.177 Published online April 1, 1993.

Clinical evaluation on transbronchial needle aspiration(TBNA) of subcarinal lymph node in lung cancer.

Yu Ho Kang¹, In Seon Choi¹, Ik Ju Jung¹, Jai Hee Park¹, Shin Seok Lee¹, Min Su Lee¹, Young Cheol Kim¹, Kyung Ok Park¹, Sang Woo Jung²

¹Department of Internal Medicine, Chonnam University Medical School, Kwangju, Korea
²Department of Pathology, Chonnam University Medical School, Kwangju, Korea

Abstract

Background
Accurate staging of bronchogenic carcinoma is important in determining resectability and metastasis of tumor to the subcarinal nodes is generally belieγed to indicate poor prognosis. The technique of Transbronchial needle aspiration (TBNA) has offered a safe & effective way to asscess mediastinal lymph node involvement in the staging of lung cancer. We performed TBNA in patients who were suspected lung cancer to evaluate the clinical usefulness of the TB NA.
Methods
TBNA of the subcarinal lymph node was performed at the time of initial diagnostic bronchoscopy in 60 patients with suspected lung cancer, and 42 cases of histologically proved bronchogenic cancer were analyzed.
Results
The frequency of adequate samples by transbronchial needle aspiration (TBN A) was 81 % and the positive rate of malignant cells by TBNA was 14.7%. There were no differences in positive rates by tumor cell types. In patients with thickened carina on bronchoscopy, the TB N A was positive in 33.3% as compared to 5.3% of normal carina on bronchoscopy, and the difference was statistically significant (p<0.05). In patients with enlarged subcarinal lymph node on chest CT, the positive rate of malignant cells (50.0%) was higher than that of normal sized subcarinal lymph node on chest CT (4.8%) (p < 0.01). There were no specific complications in the TBN A procedure.
Conclusion
TBN A is a relatively safe procedure and it offers the possibility of avoiding the cost and morbidity of surgical staging in patients especially those whose carina is thickened on bronchoscopy and whose subcarinal LN was enlarged on chest CT.

Key Words: TBNA, Bronchogenic cancer, Mediastinal lymph node, Subcarinal Iymph node