Endobronchial Ultrasound Features for Evaluation of Mediastinal and Hilar Lymph Nodes
Abstract Background. The aim of the study was to evaluate the utility of Endobronchial ultrasound (EBUS) features included elastography and B-mode features for differentiating malignant from benign lymph nodes(LNs). Methods. 84 patients with 151 enlarged mediastinal and hilar LNs underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) were involved in the retrospective study from 1 January 2019 to 31 December 2019. Scores of EBUS elastography, EBUS B-mode features and final pathological results were recorded. Receiver operating characteristics, univariate and multivariate logistic regression analysis were used to evaluate the diagnostic yield of elastography and B-mode features for malignant LNs. Results. Total 84 patients of 151 LNs were enrolled in the single center retrospective study, which included 108 malignant nodes and 43 benign nodes obtained from 59/25 patients respectively. EBUS elastography score 4-5 differentiated malignant LNs from benign nodes with sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy 85.05%, 77.27%, 90.10%, 71.0% and 82.23% respectively. EBUS B-mode features round shape, heterogenenous echogenicity and absence of CHS showed statistical diagnostic yield by multivariate logistic analysis. ROC analysis suggested the combined AUC for elastography, round shape, absence of CHS and hetergeneous echogenicity was 0.849. Conclusions. EBUS features are effective for differentiating between benign and malignant LNs. This study was approved by the Ethics Committee of Qingdao medical college affiliated Yantai Yuhuangding Hospital (NO. 2014-111).