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Lung cancer diagnosis and management have undergone significant changes over the past decade with introduction of the minimally invasive endoscopic techniques. Endoscopic staging offers an accurate and cost-effective means of mediastinal evaluation in primary lung cancer. Quality data on performance of EBUS-TBNA in mediastinal LN staging in lung cancer led to a recent recommendation from the ACCP and ESTS to use the needle-based techniques for the initial mediastinal staging [1, 3]. When combined with EUS-FNA, EBUS-TBNA offers nearly complete assessment of the mediastinum and may have higher diagnostic accuracy than the previous gold standard, Med, in patients with metastatic disease in EBUS-TBNA- inaccessible LNs.

随着微创内镜技术的引入，肺癌诊断和治疗在过去十年中显著变化。内镜分期为原发性肺癌的纵隔评估提供了准确且经济有效的方法。EBUS-TBNA在肺癌纵隔LN分期中性能的质量数据导致ACCP和ESTS最近建议使用EBUS-TBNA进行初始纵隔分期[1,3]。当EBUS-TBNA与EUS-FNA结合时，EBUS-TBNA几乎能完整评估纵隔，并且在 EBUS-TBNA不可触及的淋巴结转移患者中的诊断准确性可能高于之前的金标准 Med。

1.patients (with metastatic disease in EBUS-TBNA- inaccessible LNs)，这个病人是不是指Med接触的病人

2.EBUS-TBNA- inaccessible，可上面说到当EBUS-TBNA与EUS-FNA结合时，EBUS-TBNA几乎能完整评估纵隔，是不是矛盾