经支气管针吸活检在非小细胞肺癌术前淋巴结分期中的应用

Role of transbronchial needle aspiration in lymph node staging of non-small-cell lung cancer before operation

目的探讨经支气管针吸活检(TBNA)在非小细胞肺癌(NSCLC)术前淋巴结分期中的临床应用价值和安全性。方法对术前胸部增强CT检查疑有纵隔/肺门淋巴结转移的26例NSCLC患者行TBNA检查,并与术后病理检查结果进行对比。结果 TBNA的敏感性、特异性、准确性、阳性预测值和阴性预测值,分别是76%(38/50)、100%(31/31)、85.2%(69/81)、100%(38/38)和72.1%(31/43)。病理分型总符合率为92.3%(24/26)。术前采用TBNA的c-N分期与p-N分期对比准确率可达92.3%(24/26)。全组无严重并发症发生。结论经TBNA进行NSCLC术前淋巴结分期,具有较高的临床实用价值和安全性。

Objective To explore the role and safety of transbronchial needle aspiration(TBNA) in lymph node staging of non-small-cell lung cancer(NSCLC) before operation.Methods Twenty-six patients with NSCLC who were suspected mediastinal and/or hilar lymph node metastasis by contrast-enhanced computed tomography(CT) scaning underwent TBNA detection.The pathological results were compared with post-operative results.Results Overall diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of TBNA for lymph node restaging were 76%(38/50),100%(31/31),85.2%(69/81),100%(38/38) and 72.1%(31/43) respectively.The overall coincidence rate of pathologic typing was 92.3%(24/26).The overall accuracy of c-N by TBNA was 92.3%(24/26) compared with p-N.Serious complications were not observed in all patients.Conclusions TBNA for lymph node staging of NSCLC is a safe method with high clinical application value.