Comparison of 21 G and 22 G EBUS TBNA Needles Diagnostic Value in Mediastinal and Hilar Lymph Nodes

Abstract

Aim: EBUS TBNA is an important diagnostic procedure for the intrathoracic lymph nodes. 21 G, 22 G and 25 G needles are used for sampling. Better samples can be expected to be taken via 21 G needle, as the inner diameter of 21 G needle is larger. However, the results of the studies comparing 21 G and 22 G needles are controversial. Methods: The study population consists of patients with EBUS TBNA performed via 21 G needles (Group 1; n=40) and the patients for whom 22 G needles used (Group 2; n=40). The data of patients were retrospectively analyzed. ROSE was performed for all samples. Results: The sensitivity, specificity and diagnostic accuracy of the procedure with 21 G needle was 95%, 85%, 93%, respectively. The diagnostic accuracy of 21 G needle was found to be higher than that of 22 G needle (93% versus 80%). In the procedure performed with 21 G needle, fewer samples were sufficient for the diagnosis than 22 G needle (r = 0.03, p <0.05). Conclusion: The diagnostic accuracy rate of 21 G needle was higher than 22 G needle. According to that result, it is better to prefer 21 G needle. With a 21 G needle, a smaller number of sample was sufficient for diagnosis than a 22 G needle. Diagnostic opportunity with less sample obtained with 21 G needle may provide time advantage to the cytopathologist who performs ROSE. Due to this advantage, in EBUS TBNA with ROSE, 21 G needles can be prioritized.

Keywords

• endobronchial ultrasound-guided transbronchial needle aspiration (ebus-tbna);
• rapid on site evaluation (rose);
• 21 gauge needle;
• 22 gauge needle
• endobronşiyal ultrason kılavuzluğunda transbronşiyal iğne aspirasyonu (ebus-tbna);
• hızlı yerinde değerlendirme (rose);
• 21 gauge i̇ğne;
• 22 gauge i̇ğne