Researchers at the University of Missouri School of Medicine have developed a new scoring system for a common lung cancer diagnostic test that may help physicians better understand the risk for malignancy when evaluating patients.

Endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TBFNA) is a minimally invasive procedure often used for the initial diagnosis of lung cancers. The test uses a thin, flexible scope that passes through the mouth and into the lungs to remove a small piece of tissue for evaluation. The test is commonly used because it can provide a rapid cancer diagnosis without the need for an invasive open procedure.

Lester Layfield, MD, MU School of Medicine.

Lester Layfield, MD, MU School of Medicine.

“The EBUS-TBFNA procedure is a diagnostic tool for lung cancer that yields proven results,” says Lester Layfield, MD, professor and chair of the department of pathology and anatomical sciences at the MU School of Medicine and lead author of a study recently published in the Journal of the American Society of Cytopathology.1 “The test categorizes the results as ‘benign,’ ‘non-diagnostic,’ ‘atypical,’ ‘suspicious for malignancy,’ or ‘malignant.’ Our goal with this study was to understand the risk of cancer associated with each category.”

Layfield’s research team evaluated information from 136 patients who received a diagnosis following the EBUS-TBFNA procedure. The same patients then had an open surgical procedure to confirm whether the tissue was cancerous or benign.

Researchers found that the EBUS-TBFNA tool provided an accurate positive diagnosis of lung cancer 84% of the time and an accurate negative diagnosis of lung cancer 68% of the time. The study also provided the research team with an estimation of malignancy risks for each category, which may help doctors offer patients enhanced care and counseling, Layfield says.

For more information, visit MU School of Medicine.


  1. Layfield LJ, Esebua M, Schmidt RL, et al. Malignancy risk associated with the EBUS-FNA diagnostic categories nondiagnostic, benign, atypical, suspicious for malignancy, and malignant for mediastinal lymph node aspirate specimens. JASC. 2015;4(5):276–281; doi:10.1016/j.jasc.2015.04.004.