超声支气管镜引导下的经支气管针吸活检对肺癌的诊断价值

Role of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in the Diagnosis of Bronchogenic Carcinoma

背景与目的本研究旨在评价超声支气管镜引导下的经支气管针吸活检(endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)对肺癌的诊断价值和安全性。方法于2009年7月-2010年2月,对95例胸部CT检查显示纵隔/肺门淋巴结肿大和/或胸内气管或支气管旁肿块患者进行EBUS-TBNA,并未采取现场细胞学方法进行检测。结果95例患者中,其中经病理学检查和临床随访验证新发肺癌患者60例。60例肺癌患者共穿刺112组淋巴结,肺内肿块11例。60例肺癌患者中通过EBUS-TBNA明确诊断58例,假阴性2例,敏感性为96.67%、特异性100%。EBUS-TBNA过程安全,全部病例无并发症发生。结论EBUS-TBNA是诊断肺癌安全、有效的方法。

Background and objective The aim of this study is to evaluate diagnostic yield and the safety of endobronchial ultrasound-guided transbronchial needle aspiration （EBUS-TBNA） in the diagnosis of bronchogenic carcinoma. Methods Between July, 2009 and February, 2010, 95 patients with mediastinal/hilar lymphadenopathy and/or intrathoracic peritracheal or peribronchial masses previously detected with CT scan underwent EBUS-TBNA. No rapid onsite cytology was performed. Results In all 95 patients, 60 cases were newly diagnosed lung cancer through the pathological examination and clinical follow-up certification. In 60 lung cancer cases, 112 samples were obtained from lymph nodes （LNs） and 11 samples were obtained from intrapulmonary lesions. Fifty-eight cases of patients were diagnosed, false negative in 2 cases. Sensitivity and specificity of EBUS-guided TBNA method in distinguishing benign from malignant LNs or thoracic masses were 96.67% and 100%, respectively. There was any major complication in this series, the procedure was uneventful. Conclusion EBUSTBNA seemed a safe and effective technique in making bronchogenic carcinoma diagnosis for mediastinal/hilar LNs and intrapulmonary masses.