Diagnostic accuracy and safety of endoscopic ultrasound-guided fine needle biopsy for evaluating mediastinal pathologies

Table 5 Comparison of clinical, diagnostic, and procedural variables between patients with benign and malignant endoscopic ultrasound-guided fine needle biopsy tissue nature, n (%)

Variables	EUS-FNB tissue nature		P value
	Benign	Malignant
Age1, mean ± SD	52.8 ± 15.1	56.7 ± 12.5	0.238
Gender
Male	25 (55.6)	18 (56.3)	0.952
Female	20 (44.4)	14 (43.8)
Previous history of malignancy
Yes	11 (24.4)	6 (18.8)	0.553
No	34 (75.6)	26 (81.3)
Symptom status
Yes	38 (84.4)	25 (78.1)	0.479
No	7 (15.6)	7 (21.9)
Duration of symptoms1, mean ± SD	83.5 ± 75.5	62.1 ± 54.6	0.431
Initial diagnostic modality
CT scan	35 (77.8)	26 (71.2)	0.502
PET CT	10 (22.2)	6 (18.8)
Indication of EUS based on initial diagnostic findings
Mediastinal lymphadenopathy	20 (44.4)	8 (25.0)	0.254
Mediastinal lymphadenopathy with esophageal/gastric/duodenal lesion	6 (13.3)	2 (6.3)
Mediastinal lymphadenopathy with liver deposit/gall bladder/pancreatic mass	7 (15.6)	8 (25.0)
Mediastinal and hilar lymphadenopathy/with liver deposits/pulmonary nodules	9 (20.0)	8 (25.0)
Para-aortic lymphadenopathy/with esophageal lesion	1 (2.2)	3 (9.4)
Porta hepatis lymphadenopathy/with breast/gastric/duodenal lesion	2 (4.4)	3 (9.4)
Size of lymph node1, mean ± SD	1.57 ± 0.6	2.3 ± 0.9	0.009
Size of lesion/mass, median (interquartile range)	4.2 (2.6)	7.8 (3.4)	0.001
EUS procedural duration1, mean ± SD	29.6 ± 20.9	25.8 ± 16.1	0.573
Number of “needle” passes
1	8 (17.8)	8 (25.0)	0.490
2	22 (48.9)	16 (50.0)
3	14 (31.1)	6 (18.8)
4	1 (2.2)	1 (3.1)
5	0 (0.0)	1 (3.1)
EUS diagnostic adequacy
Sufficient to conclude diagnosis	41 (91.1)	32 (100.0)	0.137
Not sufficient to conclude	4 (8.9)	0 (0.0)
EUS-FNB specimen
Mediastinal lesion/with esophageal/gastric lesion	8 (17.8)	8 (25.0)	0.842
Mediastinal LN/with esophageal/ pancreatic/spleenic mass	25 (55.6)	17 (53.1)
Para-aortic mass/with gastric/duodenal lesion	4 (8.9)	3 (9.4)
Porta hepatis LN/with gastric/duodenal/Liver/pancreatic lesion	8 (17.8)	4 (12.5)
Treatment
Anti-TB drugs	8 (17.8)	2 (6.3)	< 0.001
Chemotherapy	2 (4.4)	12 (37.5)
Conservative therapy	21 (46.7)	1 (3.1)
Steroids/immunosuppressive therapy	3 (6.7)	0 (0.0)
Palliative care	2 (4.4)	3 (9.4)
PEG tube placement	2 (4.4)	1 (3.1)
Radiation therapy	0 (0.0)	3 (9.4)
Surgical resection	2 (4.4)	1 (3.1)
No treatment	5 (11.1)	9 (28.1)
Patient’s outcome
Survived	35 (77.8)	18 (56.3)	0.104
Deceased	5 (11.1)	5 (15.6)
Loss to follow-up/LAMA	5 (11.1)	9 (28.1)

¹Percentages are presented in columns.

CT: Computed tomography; PET: Positron emission computed tomography; EUS-FNB: Endoscopic ultrasound-guided fine-needle biopsy; LN: Lymph node; NET: Neuroendocrine tumor; TB: Tuberculosis; PEG: Percutaneous endoscopic gastrostomy; LAMA: Leave against medical advice.