The physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross-sectional study
Abstract Mediastinal lymph node fine needle aspiration (MLN-FNA) is a common procedure; however, the physician factor in pathological category, and anatomical site are not routinely assessed. Cytology reports for endobronchial ultrasound (EBUS)/endoscopic ultrasound (EUS) MLN-FNA specimens (8846) we...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-26962-w |
| _version_ | 1811171719956660224 |
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| author | Michael Bonert Uzma Zafar Soha Ramadan Christian Finley Jean-Claude Cutz Gary Foster Kjetil Ask Asghar Naqvi |
| author_facet | Michael Bonert Uzma Zafar Soha Ramadan Christian Finley Jean-Claude Cutz Gary Foster Kjetil Ask Asghar Naqvi |
| author_sort | Michael Bonert |
| collection | DOAJ |
| description | Abstract Mediastinal lymph node fine needle aspiration (MLN-FNA) is a common procedure; however, the physician factor in pathological category, and anatomical site are not routinely assessed. Cytology reports for endobronchial ultrasound (EBUS)/endoscopic ultrasound (EUS) MLN-FNA specimens (8846) were retrieved for July 2012–Dec 2019, classified by hierarchical free text string match algorithm into 51 diagnostic categories, four mutually exclusive diagnostic groups (benign |suspicious |malignant |insufficient), and 24 anatomical sites. Pathologist and submitting physician/surgeon bias were assessed using logistic regression and funnel plots|control charts centered on the group median (diagnostic/capture) rate. Eleven pathologists and seven submitting physician/surgeon were involved in more than 250 specimens each. Overall, the MLN-FNAs were benign|suspicious|malignant|insufficient in 46%|4%|25%|24% of specimens. Percent malignant (number of samples) varied by station; 7| 4R| 4L| 2R| 10R| 11R| 11L were respectively 21%(3,101), 27%(2,453), 19%(1,289), 41%(435), 27%(497), 24%(357), 26%(229). The number of outlier (P < 0.05/P < 0.001) pathologists of 11 from the group median rate for benign|suspicious|malignant|insufficient was 0/0| 3/1| 0/0| 3/0 respectively. The outlier (P < 0.05/P < 0.001) submitting physicians/surgeons of 7 for benign|suspicious|malignant|insufficient was 3/2| 2/2| 3/2| 3/2 respectively. The physician and anatomical site are significant predictors of MLN-FNA pathology. |
| first_indexed | 2024-04-10T17:19:47Z |
| format | Article |
| id | doaj.art-c03f7b4d7bf745578c75b5cc6ca85368 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-10T17:19:47Z |
| publishDate | 2023-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-c03f7b4d7bf745578c75b5cc6ca853682023-02-05T12:11:51ZengNature PortfolioScientific Reports2045-23222023-01-011311910.1038/s41598-022-26962-wThe physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross-sectional studyMichael Bonert0Uzma Zafar1Soha Ramadan2Christian Finley3Jean-Claude Cutz4Gary Foster5Kjetil Ask6Asghar Naqvi7Division of Anatomical Pathology, Department of Pathology and Molecular Medicine, McMaster UniversityDepartment of Pathology, Rutgers Health/St. Barnabas Medical CenterDivision of Anatomical Pathology, Department of Pathology and Molecular Medicine, McMaster UniversityDivision of Thoracic Surgery, Department of Surgery, McMaster UniversityDivision of Anatomical Pathology, Department of Pathology and Molecular Medicine, McMaster UniversityDepartment of Pathology, St. Joseph’s Healthcare HamiltonDepartment of Medicine, McMaster UniversityDivision of Anatomical Pathology, Department of Pathology and Molecular Medicine, McMaster UniversityAbstract Mediastinal lymph node fine needle aspiration (MLN-FNA) is a common procedure; however, the physician factor in pathological category, and anatomical site are not routinely assessed. Cytology reports for endobronchial ultrasound (EBUS)/endoscopic ultrasound (EUS) MLN-FNA specimens (8846) were retrieved for July 2012–Dec 2019, classified by hierarchical free text string match algorithm into 51 diagnostic categories, four mutually exclusive diagnostic groups (benign |suspicious |malignant |insufficient), and 24 anatomical sites. Pathologist and submitting physician/surgeon bias were assessed using logistic regression and funnel plots|control charts centered on the group median (diagnostic/capture) rate. Eleven pathologists and seven submitting physician/surgeon were involved in more than 250 specimens each. Overall, the MLN-FNAs were benign|suspicious|malignant|insufficient in 46%|4%|25%|24% of specimens. Percent malignant (number of samples) varied by station; 7| 4R| 4L| 2R| 10R| 11R| 11L were respectively 21%(3,101), 27%(2,453), 19%(1,289), 41%(435), 27%(497), 24%(357), 26%(229). The number of outlier (P < 0.05/P < 0.001) pathologists of 11 from the group median rate for benign|suspicious|malignant|insufficient was 0/0| 3/1| 0/0| 3/0 respectively. The outlier (P < 0.05/P < 0.001) submitting physicians/surgeons of 7 for benign|suspicious|malignant|insufficient was 3/2| 2/2| 3/2| 3/2 respectively. The physician and anatomical site are significant predictors of MLN-FNA pathology.https://doi.org/10.1038/s41598-022-26962-w |
| spellingShingle | Michael Bonert Uzma Zafar Soha Ramadan Christian Finley Jean-Claude Cutz Gary Foster Kjetil Ask Asghar Naqvi The physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross-sectional study Scientific Reports |
| title | The physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross-sectional study |
| title_full | The physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross-sectional study |
| title_fullStr | The physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross-sectional study |
| title_full_unstemmed | The physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross-sectional study |
| title_short | The physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross-sectional study |
| title_sort | physician factor and anatomical site in 8846 consecutive mediastinal lymph node aspirations in a cross sectional study |
| url | https://doi.org/10.1038/s41598-022-26962-w |
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