ArticleJournal of thoracic disease2026
Determinants of single‑pass specimen adequacy in endobronchial ultrasound-guided transbronchial needle aspiration: a real-world study.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Although endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) diagnostic yield has been widely studied, factors influencing specimen adequacy from a single puncture remain unclear. This study aimed to identify factors associated with the specimen adequacy of a single EBUS‑TBNA puncture to inform and refine procedural strategies. Methods: This single-center observational study enrolled consecutive patients undergoing EBUS-TBNA. Puncture-level data were collected, and the primary outcome was the single-pass specimen adequacy rate, assessed using the Macroscopic On-site Specimen Evaluation (MOSE) scoring system. Evaluated variables included procedure-related factors (needle pathway, operator experience), lymph-node characteristics (station, size, N stage, presence of computed tomography (CT) hypodense areas), and patient characteristics. A cumulative link mixed model (CLMM) was used to identify independent predictors of specimen adequacy. Results: A total of 426 lymph nodes (636 punctures) from 219 patients were analyzed. The median MOSE score was 2 [1, 4] and the median puncture attempts was 1 [1, 2]. In univariate analyses, lymph node size, malignant pathology, and lymph node station were associated with specimen adequacy, whereas needle pathway (central Conclusions: In this study, specimen adequacy from a single EBUS‑TBNA puncture appeared to be more closely related to malignancy and lymph node station. These findings indicate that disease‑related factors may influence single‑pass yield; however, additional studies are required to validate these results and determine their applicability across different clinical settings.
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