The Effect of the Operator Learning Curve on Diagnostic Accuracy for Lung Cancer with Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Single-Center Observational Study

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UZUN R., Uzer F.

UHOD-ULUSLARARASI HEMATOLOJI-ONKOLOJI DERGISI, cilt.31, sa.1, ss.59-65, 2021 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 31 Sayı: 1
  • Basım Tarihi: 2021
  • Doi Numarası: 10.4999/uhod.214378
  • Dergi Adı: UHOD-ULUSLARARASI HEMATOLOJI-ONKOLOJI DERGISI
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE
  • Sayfa Sayıları: ss.59-65
  • Anahtar Kelimeler: EBUS, Learning curve, Lung cancer, Diagnostic accuracy
  • Akdeniz Üniversitesi Adresli: Evet

Özet

We aimed to investigated the relationship between diagnostic accuracy of ultrasound-guided trans-bronchial needle aspiration (EBUSTBNA) and the number of procedure performed by operator. We included all consecutively attended patients undergoing EBUS-TBNA for diagnosis of lung cancer. The pathology prearations were evaluated by the same single pathologist. Rapid on-site examination (ROSE) was performed for all patients. To determine the impact of operator experience on the accuracy of EBUS-TBNA-hased diagnosis, patients were divided into three equally sized groups based on the chronological order of their EBUS-TBNA assessment. A total of 270 patients were included in the study. The most common indication for undergoing the EBUS-TBNA procedure was tumor staging (44.1%). ROC analysis revealed that the study bronchoscopist's diagnosis of malignancy based on EBUS-TBNA images were consistent with the final pathologist's diagnosis in 73% of the first 90 cases (p= 0.02), 90% of the second 90 cases (p= 0.01), and 98% of the third 90 cases (p= 0.01). In the first 90 cases, the sensitivity of the bronchoscopist's diagnosis was 74%, the specificity was 78%, the positive predictive value was 76%, and the negative predictive value was 85%. In the second 90 cases, the sensitivity was 94%, the specificity was 92%, the positive predictive value was 95%, and the negative predictive value was 95%. In the third 90 cases, the sensitivity was 98%, the specificity was 98%, the positive predictive value was 98%, and the negative predictive value was 100%. We observed that as the number of EBUS-TBNA procedures that the operator performed increased, his diagnostic accuracy approached perfection.