LAUSR

Introduction: There is no data regarding the value of endosonography techniques with use of 25 gauge needles for non-small cell lung cancer (NSCLC) staging in small mediastinal lymph nodes (MLN). Objective: To assess the diagnostic yield of endobronchial (EBUS-TBNA) and endoscopic ultrasound-guided needle aspiration (EUS-B-FNA) for small MLN in NSCLC staging with use of 25 gauge needles. Methods: Prospective, multicenter national clinical trial in consecutive, suspected or confirmed NSCLC patients, with not enlarged ( Results: 53 patients underwent endosonography after PET-CT and 186 MLN were biopsied. Combined EBUS-TBNA and EUS-B-FNA revealed metastatic MLN involvement in 16 patients (30,2%) and was false negative in 3 (5,6%), confirmed either by TEMLA in two or by SLND in one. Only in 5 (2,6%) of all 186 MLN a biopsy performed by 25 gauge needle was undiagnostic. A diagnostic sensitivity, specificity, accuracy, PPV and NPV of PET-CT were 90%, 72.7%, 79.2%, 66.7% and 92.3% and of combined endosonography were 84%, 100%, 94.3%, 100% and 91.9%, respectively. No complications after biopses were observed. Conclsion: Combined endosonographic NSCLC staging with use of 25 gauge needles is effective and safe in small nodes.