TY - T1的系统性和endosonogra相结合phic staging of lung cancer (SCORE study) JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00800-2018 VL - 53 IS - 2 SP - 1800800 AU - Crombag, Laurence M.M. AU - Dooms, Christophe AU - Stigt, Jos A. AU - Tournoy, Kurt G. AU - Schuurbiers, Olga C.J. AU - Ninaber, Maarten K. AU - Buikhuisen, Wieneke A. AU - Hashemi, Sayed M.S. AU - Bonta, Peter I. AU - Korevaar, Daniël A. AU - Annema, Jouke T. Y1 - 2019/02/01 UR - //www.qdcxjkg.com/content/53/2/1800800.abstract N2 - Guidelines recommend endosonography for mediastinal nodal staging in patients with resectable nonsmall cell lung cancer (NSCLC). We hypothesise that a systematic endobronchial ultrasound (EBUS) evaluation combined with an oesophageal investigation using the same EBUS bronchoscope (EUS-B) improves mediastinal nodal staging versus the current practice of targeted positron emission tomography (PET)-computed tomography (CT)-guided EBUS staging alone.A prospective, multicentre, international study (NCT02014324) was conducted in consecutive patients with (suspected) resectable NSCLC. After PET-CT, patients underwent systematic EBUS and EUS-B. Node(s) suspicious on CT, PET, EBUS and/or EUS-B imaging and station 4R, 4L and 7 (short axis ≥8 mm) were sampled. For patients without N2/N3 disease determined on endosonography, surgical-pathological staging was the reference standard.229 patients were included in this study. The prevalence of N2/N3 disease was 103 out of 229 patients (45%). A PET-CT-guided targeted approach by EBUS identified 75 patients with N2/N3 disease (sensitivity 73%, 95% CI 63–81%; negative predictive value (NPV) 81%, 95% CI 74–87%). Four additional patients with N2/N3 disease were found by systematic EBUS (sensitivity 77%, 95% CI 67–84%; NPV 84%, 95% CI 76–89%) and five more by EUS-B (84 patients total; sensitivity 82%, 95% CI 72–88%; NPV 87%, 95% CI 80–91%). Additional clinical relevant staging information was obtained in 23 out of 229 patients (10%).Systematic EBUS followed by EUS-B increased sensitivity for the detection of N2/N3 disease by 9% compared to PET-CT-targeted EBUS alone.In lung cancer patients, a systematic endobronchial ultrasound (EBUS) combined with an oesophageal investigation using the same EBUS bronchoscope (EUS-B) increases the sensitivity for mediastinal nodal staging by 9% compared to a targeted EBUS procedure http://ow.ly/aPqF30mJ15q ER -