Endobronchial ultrasound transbronchial needle aspiration (EBUS TBNA) is an established, minimally invasive way to sample intrathoracic abnormalities. The EBUS scope can be passed into the oesophagus to perform endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA). In cases of suspected lung cancer, a combination of the two techniques is now recommended by consensus guidelines. EBUS TBNA is usually performed by pulmonologists; however, the learning curve for EUS-B-FNA, which may be performed during the same procedure, has not been described. A multicentre, observational Australian study, using prospectively collected data from three experienced pulmonologists was conducted. Cumulative sum (cusum) analysis was used to generate visual learning curves. A total of 152 target lesions were sampled in 137 patients, with an overall sensitivity for malignancy of 94.8%. The sensitivity for malignant lesions outside of the 2009 International Association for the Study of Lung Cancer lymph node map (largely intraparenchymal lesions) was 92.9%. All three operators were competent by conventional cusum criteria. There was one case of pneumothorax, and no episodes of mediastinitis or oesophageal perforation were observed. Our data suggest that experienced pulmonologists can safely and accurately perform EUS-B-FNA, with a high diagnostic sensitivity for both lymph node and non-nodal lesions. Endoscopic ultrasound fine-needle aspiration can be performed with an endobronchial scope http://ow.ly/LtPd30fwkn1

中文翻译：

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由经验丰富的肺科医生进行的内镜超声细针穿刺：累积分析

支气管内超声经支气管针吸活检 (EBUS TBNA) 是一种成熟的微创方法，可用于对胸内异常进行采样。EBUS 内窥镜可通过支气管镜引导的细针抽吸 (EUS-B-FNA) 进入食道进行内窥镜超声检查。在疑似肺癌的情况下，共识指南现在推荐将这两种技术结合使用。EBUS TBNA 通常由肺科医生进行；然而，EUS-B-FNA 的学习曲线可能在同一程序中执行，尚未描述。使用三位经验丰富的肺病学家前瞻性收集的数据进行了一项多中心、观察性的澳大利亚研究。累积总和 (cusum) 分析用于生成视觉学习曲线。137例患者共采集152个靶病灶，对恶性肿瘤的总体敏感性为 94.8%。对 2009 年国际肺癌研究协会淋巴结图（主要是实质内病变）以外的恶性病变的敏感性为 92.9%。所有三个操作员都能够胜任传统的累积标准。1例气胸，未见纵隔炎或食管穿孔。我们的数据表明，经验丰富的肺科医生可以安全、准确地进行 EUS-B-FNA，对淋巴结和非淋巴结病变具有很高的诊断敏感性。内窥镜超声细针抽吸可以使用支气管镜进行 http://ow.ly/LtPd30fwkn1 对 2009 年国际肺癌研究协会淋巴结图（主要是实质内病变）以外的恶性病变的敏感性为 92.9%。所有三个操作员都能够胜任传统的累积标准。1例气胸，未见纵隔炎或食管穿孔。我们的数据表明，经验丰富的肺科医生可以安全、准确地进行 EUS-B-FNA，对淋巴结和非淋巴结病变具有很高的诊断敏感性。内窥镜超声细针抽吸可以使用支气管镜进行 http://ow.ly/LtPd30fwkn1 对 2009 年国际肺癌研究协会淋巴结图（主要是实质内病变）以外的恶性病变的敏感性为 92.9%。所有三个操作员都能够胜任传统的累积标准。1例气胸，未见纵隔炎或食管穿孔。我们的数据表明，经验丰富的肺科医生可以安全、准确地进行 EUS-B-FNA，对淋巴结和非淋巴结病变具有很高的诊断敏感性。内窥镜超声细针抽吸可以使用支气管镜进行 http://ow.ly/LtPd30fwkn1 没有观察到纵隔炎或食管穿孔的发作。我们的数据表明，经验丰富的肺科医生可以安全、准确地进行 EUS-B-FNA，对淋巴结和非淋巴结病变具有很高的诊断敏感性。内窥镜超声细针抽吸可以使用支气管镜进行 http://ow.ly/LtPd30fwkn1 没有观察到纵隔炎或食管穿孔的发作。我们的数据表明，经验丰富的肺科医生可以安全、准确地进行 EUS-B-FNA，对淋巴结和非淋巴结病变具有很高的诊断敏感性。内窥镜超声细针抽吸可以使用支气管镜进行 http://ow.ly/LtPd30fwkn1