支气管内超声引导经支气管淋巴结针吸活检术在肺癌纵隔淋巴结分期诊断应用研究

Application of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA) for mediastinal lymph node staging in lung cancer

支气管内超声引导经支气管淋巴结针吸活检术(EBUS-TBNA)是肺癌纵隔淋巴结分期的新方法,其具有微创、安全等特点,进行纵隔淋巴结分期具有较高的灵敏度和特异度,优于CT、PET和经支气管淋巴结针吸活检术(TBNA),和纵隔镜相当,联合EBUS-TBNA和经食管内镜超声引导细针抽吸活检术(EUS-FNA)可获得几乎完全的纵隔淋巴结分期。可一线应用于肺癌的纵隔淋巴结分期及纵隔淋巴结病变活检。EBUS-TBNA不足之处是相对较高的假阴性率,对于阴性患者,建议行进一步的侵袭性分期方法如纵隔镜检查。

Endobronchial ultrasound-guided transbronchial needle aspiration（EBUS-TBNA） is a novel approach for mediastinal lymph node staging in lung cancer,with minimal invasiveness and good safety.EBUS-TBNA shows distinct advantages in sensitivity and specificity over CT,PET and conventional transbronchial needle aspiration（TBNA） for mediastinal lymph node staging,and may be a viable alternative to mediastinoscopy.Combination of EBUS-TBNA and transesophageal endoscopic ultrasound-guided fine-needle aspiration（EUS-FNA） may allow for nearly complete staging of the mediastinum,and therefore can be a first-line choice for lymph node staging and mediastinal lymph node biopsy.Owing to a relatively high rate of false negative results,patients who test negative by EBUS-TBNA may need further invasive procedures（such as mediastinoscopy） for a confirmation.