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  1 / 1573 MEDLINE  
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PMID:27773666
Autor:Korevaar DA; Crombag LM; Cohen JF; Spijker R; Bossuyt PM; Annema JT
Endereço:Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands. Electronic address: d.a.korevaar@amc.uva.nl.
Título:Added value of combined endobronchial and oesophageal endosonography for mediastinal nodal staging in lung cancer: a systematic review and meta-analysis.
Fonte:Lancet Respir Med; 4(12):960-968, 2016 12.
ISSN:2213-2619
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: Guidelines recommend endosonography with fine-needle aspiration for mediastinal nodal staging in non-small-cell lung cancer, but most do not specify whether this should be through endobronchial endoscopy (EBUS), oesophageal endoscopy (EUS), or both. We assessed the added value and diagnostic accuracy of the combined use of EBUS and EUS. METHODS: For this systematic review and random effects meta-analysis, we searched MEDLINE, Embase, BIOSIS Previews, and Web of Science, without language restrictions, for studies published between Jan 1, 2000, and Feb 25, 2016. We included studies that assessed the accuracy of the combined use of EBUS and EUS in detecting mediastinal nodal metastases (N2/N3 disease) in patients with lung cancer. For each included study, we extracted data on the age and sex of participants, inclusion criteria regarding tumour stage on imaging, details of the endoscopic testing protocol, duration of each endoscopic procedure, number of lymph nodes sampled, serious adverse events occurring during the endoscopic procedures, the reference standard, and 2 × 2 tables for EBUS, EUS, and the combined approach. We evaluated the added value (absolute increase in sensitivity and in detection rate) of the combined use of EBUS and EUS in detecting mediastinal nodal metastases over either test alone, and the diagnostic accuracy (sensitivity and negative predictive value) of the combined approach. This study is registered with PROSPERO, number CRD42015019249. FINDINGS: We identified 2567 unique manuscripts by database search, of which 13 studies (including 2395 patients) were included in the analysis. Median prevalence of N2/N3 disease was 34% (range 23-71). On average, addition of EUS to EBUS increased sensitivity by 0·12 (95% CI 0·08-0·18) and addition of EBUS to EUS increased sensitivity by 0·22 (0·16-0·29). Mean sensitivity of the combined approach was 0·86 (0·81-0·90), and the mean negative predictive value was 0·92 (0·89-0·93). The mean negative predictive value was significantly higher in studies with a prevalence of 34% or less (0·93 [95% CI 0·91-0·95]) compared with studies with a prevalence of more than 34% (0·89 [0·85-0·91]; p=0·013). We found no significant differences in mean sensitivity and negative predictive value between studies that did EBUS first or EUS first, or between studies that used an EBUS-scope or a regular echoendoscope to do EUS. INTERPRETATION: The combined use of EBUS and EUS significantly improves sensitivity in detecting mediastinal nodal metastases, reducing the need for surgical staging procedures. FUNDING: No external funding.
Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW


  2 / 1573 MEDLINE  
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PMID:29390283
Autor:Muraoka S; Tsuchida K; Iwasaki M; Izawa N; Jinnai H; Komatsubara T; Tsunemi M; Sakuma F; Kashima K; Fukushi K; Hiraishi H
Endereço:Department of Gastroenterology, Dokkyo Medical University, Shimotsuga, Tochigi, Japan.
Título:A case report of gastric linitis plastica diagnosed by endoscopic ultrasound-guided fine needle aspiration.
Fonte:Medicine (Baltimore); 96(50):e8937, 2017 Dec.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:RATIONALE: There is currently no consensus on the ideal method for obtaining deep tissue biopsy material of advanced gastric LP. EUS-FNA has potential as a useful diagnostic method. Thus, we report the case of a 46-year-old male with advanced gastric linitis plastica (LP) who was diagnosed using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). PATIENT CONCERNS: The patient underwent esophagogastroduodenoscopy (EGD) because of epigastric pain at a local clinic. The gastric fold swelling was pointed out by the EGD and despite the suspected advanced gastric LP, biopsy indicated Group 1. Repeat biopsy did not suggest malignancy. The patient was referred to our institution. DIAGNOSES: Endoscopic ultrasound indicated gastric wall thickening mainly in the greater curvature of the gastric corpus. Low-level echoes were detected throughout the entire gastric wall, and gastric wall layers had been disappeared. EUS-FNA of the gastric wall indicated signet ring cell carcinoma. INTERVENTIONS: As a result of EUS - FNA, it became a policy to administer chemotherapy. In accordance with the patient's wishes, he was referred to another institution for chemotherapy. OUTCOMES: Normal biopsy did not give a definitive pathological diagnosis, and final diagnosis of LP was obtained with EUS-FNA. LESSONS: We expect that EUS-FNA can be utilized as a relatively non-invasive, highly sensitive, and specific pathological diagnostic procedure for advanced gastric LP. EUS-FNA should be considered as one way to obtain a deep tissue biopsy of advanced gastric LP.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  3 / 1573 MEDLINE  
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PMID:27770251
Autor:Tertemiz KC; Alpaydin AO; Karacam V
Endereço:Department of Pulmonary Diseases, Dokuz Eylul University Medical Faculty, 35340, Balcova, Izmir, Turkey. tkemalcan@yahoo.com.
Título:The role of endobronchial ultrasonography for mediastinal lymphadenopathy in cases with extrathoracic malignancy.
Fonte:Surg Endosc; 31(7):2829-2836, 2017 Jul.
ISSN:1432-2218
País de publicação:Germany
Idioma:eng
Resumo:INTRODUCTION: Many extrathoracic malignancies can metastasize to lungs and mediastinal lymph nodes. Whether mediastinal lesions are metastasis in these patients changes staging, prognosis, and treatment strategy. In this study, we aimed to find out the contribution of EBUS-TBNA to the diagnosis in cases with extrathoracic malignancy. MATERIALS AND METHODS: Patients who had been previously diagnosed as extrapulmonary solid organ malignancy and in whom mediastinal or hilar lymphadenopathy developed during their follow-up and EBUS-TBNA was applied for diagnostic purposes were retrospectively included in this study. RESULTS: A total of 91 patients consisting of 35 females (38.5 %) and 56 males (61.5 %) were included in the study. The mean age of the patients was 60.5 (±11.4). Malignancy was not observed in 54 (59.3 %) patients; primary malignancy metastasis was detected in 33 (36.3 %) patients, and primary lung cancer was detected in 4 (4.4 %) patients with EBUS-TBNA. The sensitivity of EBUS-TBNA in extrathoracic malignancies was determined as 90.2 %; its specificity was determined as 100 %, its negative predictive value as 92.5 %, its positive predictive value as 100 %, and its diagnostic accuracy as 95.6 %. The highest rate was determined in the left lower paratracheal lymph node when they were examined in terms of malignancy detection rate in lymph node stations. CONCLUSION: EBUS-TBNA is a minimally invasive method with quite a low complication rate that does not require general anesthesia. It should be the first step method to be used in the diagnosis of mediastinal and hilar lymphadenopathies seen in extrathoracic malignancies since it has high diagnostic accuracy, sensitivity, and specificity. EBUS-TBNA significantly reduces the need for surgical intervention. Further surgical interventions can be planned in patients in whom diagnostic competence is not ensured.
Tipo de publicação: JOURNAL ARTICLE


  4 / 1573 MEDLINE  
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PMID:29248128
Autor:Tabchi S; Kassouf E; Rassy EE; Kourie HR; Martin J; Campeau MP; Tehfe M; Blais N
Endereço:Medical Oncology Department, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Título:Management of stage III non-small cell lung cancer.
Fonte:Semin Oncol; 44(3):163-177, 2017 06.
ISSN:1532-8708
País de publicação:United States
Idioma:eng
Resumo:Optimal management of patients with locally advanced non-small cell lung cancer remains challenging in the context of this heterogeneous disease. Despite aggressive therapeutic approaches, survival benefits are still unsatisfactory for what might be viewed as a localized malignancy. A combined modality approach offers patients superior outcomes, especially because technological advances and refined surgical procedures now provide better results with fewer complications. Nevertheless, several features of therapy remain controversial and lack formal prospective data. Traditional cytotoxic chemoradiation therapy may have reached a plateau and future perspectives opting to integrate molecularly targeted agents and immunotherapy might be the way to improve outcomes in this disease subset.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  5 / 1573 MEDLINE  
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PMID:29328105
Autor:Sijan G; Kozarski J; Stepic N; Milojevic S; Stefanovic D; Tatomirovic Z; Jaukovic L; Vesanovic S; Rajovic M
Título:Validity of ultrasound-guided aspiration needle biopsy in the diagnosis of micrometastases in sentinel lymph nodes in patients with cutaneous melanoma.
Fonte:Vojnosanit Pregl; 73(10):934-40, 2016 Oct.
ISSN:0042-8450
País de publicação:Serbia
Idioma:eng
Resumo:Background/Aim: Cutaneous melanoma is one of the most aggressive solid cancers, that develops local, regional and distant metastases. The presence of metastases in lymph nodes is in correlation with Breslow tumor thickness. According to various researches, in melanoma with more than 4 mm Breslow thickness, lymph node micrometastases can be found in 60-70% of cases. Sentinel lymph nodes biopsy is a diagnostic procedure for lymph node micrometastasis detection, which is necessary for disease staging. In recent studies, ultrasound-guided fine needle aspiration with cytology (US FNAC) of the sentinel lymph node was used as less invasive procedure, but is not accepted as the standard procedure. The goal of this work was to define sensitivity, specification and precision of the ultrasound-guided fine needle aspiration method in comparison with standard sentinel lymph node biopsy. Methods: After obtaining the Ethics Committee's permission, from 2012 to 2014 a total of 60 patients with cutaneous melanoma were enrolled, and divided into three groups: group I with thin melanoma, group II with intermediate thickness melanoma and group III with thick melanoma. The presence of micrometastases in sentinel regional lymph nodes was analyzed by US FNAC. The results obtained were compared to sentinel lymph nodes biopsy (SLNB) results. The golden standard for calculating the specific, sensitive and precise characteristics of the method of US FNAC of sentinel lymph nodes was histopathologic lymph node examination of sentinel lymph nodes acquired through biopsy. Results: Detection rate of US FNAC was 0% in the group I, 5% in the group II and 30% in the group III. SLNB detection rates were: 10% in the group I, 15% in the group II, and 45% in the group III. In melanoma thicker than 4 mm, 15% of the patients were false negative by US FNAC. The sensitivity of US FNAC for all the patients was 50%: in the group I, 0%; in the group II, 33.3%; and in the group III, 66.6%. The method specificity for all examined patients was 100% and accuracy 88%: group I, 90%; group II, 90%; group III, 85%. The FNAC and SLNB micrometastasis detection rate was significantly higher in melanoma with Breslow thickness > 4 mm (group 3) in comparison to thin and intermediate thickness tumors. Conclusion: The method of ultrasound-guided fine needle aspiration of sentinel lymph nodes, according to its sensitivity, has a place in the diagnostics of micrometastasis in regional lymph nodes only in thick melanoma, but not in thin and intermediary thickness melanoma. The results must be confirmed in a larger number of patients. If this observation could be confirmed, it would rationalize treatment of patients with thick melanoma, decrease the number of operations and shorten the time to make the diagnosis.
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; VALIDATION STUDIES


  6 / 1573 MEDLINE  
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PMID:28449429
Autor:Oh Y; Choi Y; Son SM; Lee J; Kim Y; Han JH; Park SM
Endereço:Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
Título:Pancreatic Lymphoepithelial Cysts Diagnosed with Endosonography-guided Fine Needle Aspiration.
Fonte:Korean J Gastroenterol; 69(4):253-258, 2017 Apr 25.
ISSN:2233-6869
País de publicação:Korea (South)
Idioma:eng
Resumo:Although lymphoepithelial cysts (LECs) of the pancreas are benign lesions, most of them have been treated with surgical resection due to diagnostic difficulty. We report a 66-year-old woman diagnosed with pancreatic LECs. Abdominal ultrasound revealed two masses in the pancreas, which were not visible on the abdominal computed tomography. In an abdominal magnetic resonance imaging, pancreas lesions showed solid tumors, which revealed a low signal intensity on T1-, moderate high signal intensity on T2 weighted images, and homogeneous delayed enhancement in the portal venous phase. Endosonography (EUS) revealed two hypoechoic round masses measuring 1.5 cm and 4.5 cm in the body and tail of the pancreas, respectively. EUS-guided fine needle aspiration (FNA) revealed squamous cells, amorphous keratinous debris, and lymphocytes. The patient was diagnosed with LECs of the pancreas. For the duration of the follow-up period of two years, imaging studies were unchanged. EUS-FNA is useful in making a definite diagnosis and avoiding unnecessary surgery. This is the first case of pancreatic LECs diagnosed with EUS-FNA in Korea.
Tipo de publicação: CASE REPORTS


  7 / 1573 MEDLINE  
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PMID:29258068
Autor:Minaga K; Takenaka M; Katanuma A; Kitano M; Yamashita Y; Kamata K; Yamao K; Watanabe T; Maguchi H; Kudo M
Endereço:Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
Título:Needle Tract Seeding: An Overlooked Rare Complication of Endoscopic Ultrasound-Guided Fine-Needle Aspiration.
Fonte:Oncology; 93 Suppl 1:107-112, 2017.
ISSN:1423-0232
País de publicação:Switzerland
Idioma:eng
Resumo:Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been widely used for diagnosis of both inflammatory and tumor lesions located in and adjacent to the gastrointestinal tract. EUS-FNA has been considered to be a safe technique with few complications, as shown in recent review articles in which EUS-FNA-related morbidity and mortality rates were reported to be <1%. It should be noted, however, that needle tract seeding, although uncommon, can occur after diagnostic EUS-FNA and that this complication affects the prognosis of patients. Although an accurate value for the frequency of needle tract seeding caused by EUS-FNA has not been reported, the numbers of case reports on needle tract seeding have been rapidly increasing, especially in Japan. These case reports regarding EUS-FNA-related needle tract seeding prompted us to reevaluate the safety of EUS-FNA because this complication may have a significant influence on patients' prognoses. In this review, we summarize the clinical features and outcomes of needle tract seeding after EUS on the basis of the previously reported cases and provide useful information to prevent and reduce this serious complication.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  8 / 1573 MEDLINE  
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PMID:29187455
Autor:Erber R; Stöhr R; Herlein S; Giedl C; Rieker RJ; Fuchs F; Ficker JH; Hartmann A; Veltrup E; Wirtz RM; Brueckl WM
Endereço:Institute of Pathology, University Hospital, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany Ramona.erber@uk-erlangen.de.
Título:Comparison of mRNA Expression Measured with the CheckPoint Typer® Assay with PD-L1 Protein Expression Assessed with Immunohistochemistry in Non-small Cell Lung Cancer.
Fonte:Anticancer Res; 37(12):6771-6778, 2017 12.
ISSN:1791-7530
País de publicação:Greece
Idioma:eng
Resumo:BACKGROUND: Immunohistochemical (IHC) assessment of programmed death-ligand 1 (PD-L1) in non-small cell lung cancer (NSCLC) has become important since the development of anti-PD-1/-PD-L1 directed drugs. Various PD-L1 antibodies and cut-offs have been used in different trials to predict response to these drugs, thus comparison of those studies is difficult. We compared PD-L1 mRNA expression measured by RT-qPCR with PD-L1 protein expression evaluated by IHC. Moreover, we investigated the impact of different tumour tissue acquisition methods on the reliability of PD-L1 measurement techniques. MATERIALS AND METHODS: NSCLC cases (N=22), including n=9 mediastinal lymph node biopsies acquired by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and n=5 metastases, were evaluated prospectively for PD-L1 protein on tumor cells (TC) and immune cells (IC) using E1L3N and 28-8 antibodies and PD-L1 mRNA using the CheckPoint TYPER® assay. RESULTS: In primary NSCLC tissues, agreement between PD-L1 mRNA and TC staining using the 28-8 antibody was excellent (ĸ=0.85, p=0.0002). Comparing both PD-L1 antibodies against each other showed a kappa value of 0.58 (p=0.0106). In EBUS-TBNA, PD-L1 mRNA correlated perfectly with the 28-8 antibody (ĸ=1.0, p=0.0023). PD-L1 mRNA levels significantly differed when comparing 28-8 TC staining of tumours >49% with 1-49% and 0% (p=0.0040; p=0.0081, respectively). In metastatic lesions, differences between PD-L1 mRNA and IHC became apparent (ĸ=0.2, p=0.2525). CONCLUSION: Testing of PD-L1 mRNA and 28-8 IHC showed an excellent agreement in NSCLC samples including mediastinal lymph node biopsies. Since PD-L1 expression in >50% TC detected by 28-8 IHC can be reliably detected by RT-qPCR, quantitative PD-L1 mRNA determination should be considered as an alternative to IHC as there is no interobserver variability in RNA results.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (B7-H1 Antigen); 0 (CD274 protein, human); 0 (RNA, Messenger)


  9 / 1573 MEDLINE  
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PMID:29187467
Autor:Hoffmann MA; Taymoorian K; Ruf C; Gerhards A; Leyendecker K; Stein T; Jakobs FM; Schreckenberger M
Endereço:Department of Nuclear Medicine, Johannes Gutenberg-University, Mainz, Germany manuhoffmann@web.de.
Título:Diagnostic Performance of Multiparametric Magnetic Resonance Imaging and Fusion Targeted Biopsy to Detect Significant Prostate Cancer.
Fonte:Anticancer Res; 37(12):6871-6877, 2017 12.
ISSN:1791-7530
País de publicação:Greece
Idioma:eng
Resumo:BACKGROUND/AIM: Multiparametric magnetic resonance imaging combined with ultrasound-fusion-targeted biopsy of the prostate intends to increase diagnostic precision, which has to be clarified. PATIENTS AND METHODS: We performed multiparametric magnetic resonance imaging followed by ultrasound-fusion-guided perineal biopsy in 99 male patients with elevated prostate-specific-antigen and previous negative standard biopsy-procedures. RESULTS: In 33/99 patients (33%) no malignancy could be confirmed by histopathology. Low-grade carcinomas (Gleason-Score 6+7a) were found in 42/66 (64%) and high-grade carcinomas (Gleason-Score ≥7b) in 24/66 (36%) men. A high-grade carcinoma corresponded to PI-RADS 4 or 5 (suspected malignancy) in 21/24 cases, which accounted for a sensitivity of 88% and negative-predictive-value of 85% (p=0.002). Differentiation between high-/low-grade carcinomas (Gleason-Score ≤7a vs. ≥7b) by means of PI-RADS related to a sensitivity of 88% and a negative-predictive-value of 70% (p=0.74). CONCLUSION: The results support the view that multiparametric magnetic resonance imaging/ultrasound-fusion-guided biopsy promotes considerably higher detection rates of clinically relevant prostate malignancies than do conventional diagnostic procedures. With regard to differentiation between high- and low-grade carcinomas, no significant difference was demonstrated.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:EC 3.4.21.77 (Prostate-Specific Antigen)


  10 / 1573 MEDLINE  
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PMID:29054229
Autor:Kayawake H; Chen-Yoshikawa TF; Oda H; Motoyama H; Hamaji M; Menju T; Aoyama A; Sato T; Sonobe M; Date H
Endereço:Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Título:Complications of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration.
Fonte:Ann Thorac Surg; 104(5):e363-e365, 2017 Nov.
ISSN:1552-6259
País de publicação:Netherlands
Idioma:eng
Resumo:Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is considered useful for the staging and diagnosis of lung cancer or thoracic lymph node enlargement; however, little is known about its complications. Between July 2009 and November 2016, 413 patients underwent EBUS-TBNA, and four complications (0.97%) occurred. Here we report four cases involving complications of EBUS-TBNA, including mediastinitis (n = 2), obstructive pneumonia (n = 1), and airway obstruction requiring admission to the intensive care unit (n = 1). All patients recovered with appropriate medical treatment. Despite their low incidence, the complications associated with EBUS-TBNA can be serious.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE



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