摘要
目的评价经支气管淋巴结针吸活检(TBNA)在纵隔肺门肿大淋巴结诊断中的作用。方法选胸部CT检查发现纵隔肺门淋巴结肿大、估计支气管镜检查不能发现气道内新生物的患者,在支气管镜检查过程中完成TBNA操作。TBNA取出的每份标本分送呼吸科实验室和病理科细胞学室检查。结果(1)入选的164例患者中80例诊断肺癌,69例诊断肺部良性疾病,其他类型恶性肿瘤2例,13例最终无明确诊断。(2)164例患者共穿刺260个部位,463针,其中TBNA穿刺成功445针(96.1%)。(3)80例肺癌患者中,TBNA总结果阳性66例(82.5%),其中25例患者TBNA结果是惟一病理学证据。80例肺癌患者共穿刺122枚淋巴结,其中TBNA结果阳性80枚(65.6%)。(4)TBNA结果的阳性率在小细胞肺癌(SCLC)和直径≥3cm淋巴结中阳性率稍高,但差异无统计学意义。(5)2006年6月1日-2007年12月31日,64例(64/87,73.5%)患者可获得明确组织学标本。其中TBNA穿刺物病理诊断结节病阳性率为53.3%(8/15),诊断肺癌阳性率为78.6%(33/42)。(6)100例(61.0%)患者穿刺部位少量出血。结论TBNA安全性好,对肺癌的诊断和分期判定有很大帮助,对肺部良性疾病的诊断亦有一定帮助。
Objective To evaluate the role of transbrochial needle aspiration (TBNA) in the diagnosis of patients with enlarged mediastinal and/or hilar lymph node. Methods Patients with mediastinal and/or hilar lymphoadenopathy proven by CT scan were eligible for TBNA as reported. All specimens were directly and instantly smeared for pathological examination. Results From June 1 2004 to December 31 2007, 164 patients were examined: including 80 lung cancers, 69 lung bengin diseases, 2 other malignancy tumor, and 13 without definite diagnosis. Total 260 lymph nodes were punctured. TBNA procedures were successfully carried out in 445/463 (96. 1% ). Sensitivity of TBNA was 82. 5% (66/80) in patients who had been proven to suffer from bronchogenic carcinoma. There were 25 patients that diagnosis of lung cancer was pathologically determined by TBNA only. A total of 122 lymph nodes in the 80 lung cancer patients were aspirated by TBNA with a positive rate of 65.6% ( 80/122 ). Severe complications were rare except small amount of bleeding at the TBNA site ( 100/164, 61.0% ). From June 1 2006 to December 31 2007, lymph node tissues able to make histology diagnosis were yield in 73.5% (64/87) patients. Through histology pathology, the sensitivities of TBNA were 53.3% (8/15) for sarcoidosis and 78. 6% (33/42) for lung cancer. Conclusion TBNA is quite safe and helpful in diagnosis and staging of bronchogenic carcinoma, and in diagnosis of benign lung diseases.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2009年第2期133-135,共3页
Chinese Journal of Internal Medicine