True Negative Predictive Value of Preoperative Staging Endosonography by Combined Endobronchial Ultrasound and Endoscopic Ultrasound in Non-Small Cell Lung Cancer

CHEST Journal ◽  
2017 ◽  
Vol 152 (4) ◽  
pp. A860
Author(s):  
Pravachan Hegde ◽  
Vicky Thiffault ◽  
Vipul Jain ◽  
Akshatha Gowda ◽  
Pasquale Ferraro ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Negative Predictive Value ◽  
Endoscopic Ultrasound ◽  
Predictive Value ◽  
Preoperative Staging ◽  
Small Cell ◽  
Endobronchial Ultrasound ◽  
Small Cell Lung ◽  
True Negative

scholarly journals EP1.13-02 Negative Predictive Value of EBUS-TBNA for Mediastinal Staging of Non-Small Cell Lung Cancer

2019 ◽  
Vol 14 (10) ◽  
pp. S1031-S1032
Author(s):  
N. Anagnostopoulos ◽  
K. Cholidou ◽  
D. Ampazis ◽  
D. Grapsa ◽  
R. Trigidou ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Negative Predictive Value ◽  
Cell Lung Cancer ◽  
Predictive Value ◽  
Small Cell ◽  
Small Cell Lung ◽  
Mediastinal Staging

scholarly journals High Sensitivity of PD-L1 analysis from pleural effusion in non-small cell lung cancer

2020 ◽  
pp. 00787-2020
Author(s):  
Lars Hagmeyer ◽  
Stephan Schäfer ◽  
Marianne Engels ◽  
Anja Pietzke-Calcagnile ◽  
Marcel Treml ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pleural Effusion ◽  
Small Cell Lung Cancer ◽  
Negative Predictive Value ◽  
Cell Lung Cancer ◽  
Predictive Value ◽  
High Sensitivity ◽  
Small Cell ◽  
Small Cell Lung ◽  
Sensitivity Specificity

BackgroundPD-1/PD-L1 immune checkpoint inhibitors have been approved for monotherapy of metastatic non-small cell lung cancer (mNSCLC) depending on tumor cells' PD-L1 expression. Pleural effusion (PE) is common in mNSCLC. The significance of immunocytochemistry PD-L1 analysis from PE samples is unclear.Aim of the studyTo analyse the sensitivity regarding immunocytochemistry PD-L1 analysis of PE in NSCLC as compared to immunohistochemistry of pleural biopsies.Patients and Methods50 consecutive subjects (17 female, median age 72.5, 7 never-smokers) were enrolled in this prospective controlled two-center study. Inclusion criteria were PE, suspected or known lung cancer, indication for pleural puncture and thoracoscopy, written informed consent. Immunocytochemistry and immunohistochemistry PD-L1 analyses were performed with the Dako-PDL1-IHC-22C3pharmDx assay. Analysis for sensitivity, specificity, positive (PPV) and negative predictive value (NPV) was performed for PD-L1 detection from PE.Results50 subjects underwent pleural puncture and thoracoscopy. Pathologic diagnoses were lung cancer (48), lymphoma (1), mesothelioma (1). Sensitivity, specificity, positive-predictive-value and negative-predictive-value of PD-L1-testing with expression ≥50% defined as positive were 100% (95% confidence interval 46–100%), 63%(36–84%), 45%(18–75%), 100%(66–100%), and with expression ≥1% defined as positive 86%(56–97%), 43%(12–80%), 75%(47–92%), 60%(17–93%).ConclusionPD-L1 analysis in tumor-positive PE samples shows a very high sensitivity and negative-predictive-value, especially regarding PD-L1 expression levels ≥50% (European Medicines Agency approval). Negative results are reliable and help in the decision against a first-line checkpoint inhibitor monotherapy. However, a 1% cut-off level (United States Food and Drug Administration approval) leads to a markedly lower negatve-predictive-value, making other invasive procedures necessary. (NCT02855281)

scholarly journals Evaluation of mediastinoscopy in mediastinal lymph node staging for non-small-cell lung cancer

2020 ◽  
Author(s):  
Ian Diebels ◽  
Jeroen M H Hendriks ◽  
Jan P Van Meerbeeck ◽  
Patrick Lauwers ◽  
Annelies Janssens ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Negative Predictive Value ◽  
Cell Lung Cancer ◽  
European Society ◽  
Predictive Value ◽  
Small Cell ◽  
Lymph Node Staging ◽  
Small Cell Lung ◽  
Video Assisted

Abstract OBJECTIVES The purpose of this study was to assess the quality of video-assisted cervical mediastinoscopy (VACM) in the staging of non-small-cell lung cancer (NSCLC) at the Antwerp University Hospital with a focus on test effectiveness indicators, morbidity and unforeseen pN2 results. METHODS All consecutive VACM workups of cases of NSCLC performed between January 2010 and December 2015 were included to assess overall test quality and effectiveness. Quality assurance was performed in accordance with the recommendations of the European Society of Gastrointestinal Endoscopy and European Society of Thoracic Surgeons (ESTS) where appropriate. RESULTS A total of 168 video-assisted cervical mediastinoscopies were included. A total of 91.7% of the procedures were performed in accordance with the ESTS guideline. An unforeseen pN2 staging was identified in 10 anatomical lung resections (8.6%). Statistical analysis showed no significant association between VACM performed in accordance with the ESTS guideline and the presence of pN2 positive lymph nodes [χ2 (1) = 0.61; P = 0.57] and no association between VACM performed in accordance with the ESTS guideline and overall futile thoracotomy [χ2 (1) = 0.76; P = 0.50]. Calculations revealed a sensitivity of 81.8 [95% confidence interval (CI) 69.1–90.9], specificity of 100%, positive predictive value of 100%, negative predictive value of 91.9% (95% CI 86.6–95.2) and diagnostic accuracy of 94.1% (95% CI 89.33–97.11). CONCLUSIONS Overall, 91.7% of the VACM were performed in accordance with the ESTS guideline. This process resulted in a sensitivity of 81.8%, a negative predictive value of 91.9% and an unforeseen pN2 rate of 8.6%.

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