经支气管针吸活检术对肺癌伴纵隔淋巴结转移的诊断价值

Diagnostic value of transbronchial needle aspiration for mediastinal lymphnodes in patients with lung cancer

目的探讨经支气管针吸活检术(transbronchial needle aspiration,TBNA)对肺癌伴纵隔淋巴结转移的临床诊断价值。方法对CT检查怀疑为肺癌伴纵隔淋巴结转移36例患者,在常规支气管镜检查活检和刷检后,对肿大的纵隔淋巴结应用经支气管针吸活检术(TBNA),对所获得的标本进行相应的病理学检查。结果36例患者经纤支镜检查明确诊断31例,其中,组织活检、刷检和TBNA的阳性率分别是69.4%、63.9%、61.1%,常规组织活检及刷检的阳性为75.0%。结合TBNA术的阳性率增加为86.1%。所有患者未发现明显并发症。结论TBNA术操作方便、安全,对肺癌伴纵隔淋巴结转移的患者有较高的诊断价值。

Objective To investigate the diagnostic value of transbronchial needle aspiration （TBNA） for mediastinal lymphnodes in patients with lung cancer. Methods The standard bronehoscopic procedures, clamp biopsies, bronchial brushing and TBNA were performed in 36 patients with lung cancer and mediastinal lymphnodes in CT scan of chest. The samples of TBNA for mediastinal lymphnodes and the other ways were examined pathologically and cytological. Results Positive diagnosis was obtained in 31 patients by bronchoscopic. The positive rates of clamp biopsies, bronchial brush and TBNA were 69. 4%, 63.9% and 61.1% respectively. The use of TBNA increased the diagnostic yield of bronehoscopy from 75.0% to 86. 1%. No severe complications were seen. Conclusion The technique of TBNA for mediastinal lymphnodes through bronehoseope is simple, safe with few complications. It increases bronehoseopic diagnostic value in patients with lung cancer.