支气管内超声引导下针吸活检术在肺癌伴纵隔、肺门淋巴结肿大诊断中的应用

Clinical application of endobronchial ultrasound-guided transbronchial needle aspiration in diagnosis of lung cancer with enlarged mediastinal or hilar lymph nodes

目的探讨支气管内超声引导下经支气管针吸活检(EBUS-TBNA)在肺癌伴纵隔、肺门淋巴结肿大诊断中的临床应用价值。方法对27例CT或PET-CT影像学检查提示肺部占位病变伴纵隔、肺门淋巴结肿大患者行EBUS-TBNA,标本送病理学检查。结果共穿刺32个部位淋巴结;1例因纵隔淋巴结小未能穿刺活检外,其余均成功活检,无并发症发生。活检标本获明确病理学诊断,仅有1例诊断高度异型小细胞,后经手术淋巴结活检病理证实为淋巴结反应性增生。结论 EBUS-TBNA检查用于肺癌伴纵隔、肺门淋巴结转移活检安全、准确。

Objective To evaluate the clinical application of endobronchial ultrasound-guided transbronchial needle aspiration（EBUS-TBNA）in the diagnosis of lung cancer with enlarged mediastinal or hilar lymph nodes.Methods EBUS-TBNA was performed in 27 patients with enlarged mediastinal or hilar lymph nodes reported by CT or PET-CT.The samples were examined pathologically.Results A total of 32 lymph nodes was punctured successfully without complications.One lymph node was too small to be punctured.The clear pathological diagnosis was obtained in all samples except for one sample that was diagnosed as high heterotype epithelial small cell,but the diagnosis was corrected as reactive hyperplasia of lymph node after surgical resection.Conclusion Endobronchial ultrasound-guided transbronchial needle aspiration is a safe procedure with a high accuracy for the diagnosis of lung cancer with lymph node metastasis.