TBNA在纵隔淋巴结直径〈1cm的肺癌分期中的应用

目的探讨经支气管镜针吸活检术（TBNA）对纵隔淋巴结直径〈1cm的原发性肺癌行病理学评估及确定肺癌临床分期的应用价值。方法收集2013年1月至2015年12月原发性肺癌患者52例，并P2CT检查发现伴有短径〈1cm的纵隔淋巴结，行TBNA获取淋巴结细胞或组织并送病理检查，回顾性分析患者相关临床资料。结果52例患者行TBNA检查，共获得不同部位淋巴结样本60份。病理检查结果明确为恶性淋巴结转移病变10例，良性病变41例，诊断不明确9例。TBNA对于纵径〈1cm的纵隔淋巴结评估的敏感性、特异性、准确率、阳性预测值及阴性预测值分别为90．1％、80．9％、80．0％、100％和92．7％。所有患者检查耐受性良好，无严重并发症发生。结论在疑似肺癌的患者中，无论纵隔淋巴结直径是否〈1cm．均建议排除禁忌后行TBNA取得病理检查结果以明确淋巴结分期。常规TBNA作为纵隔淋巴结病理评估手段，有创伤小、并发症少、准确性高及价格低廉等优势，在肺癌分期的应用中安全、有效、可行。

Objective To evaluate the application value of pathology assessment by transbronchial needle aspiration （ TBNA ） in primary lung cancers with mediastinal lymph nodes diameter less than 1 cm. Method Totally 52 cases （ From January 2013 to December 2015 ） were collected which had been both diagnosed as primary lung cancer and discovered with less lcm mediastinal lymph node by CT. Lymph node cells or tissues were collected by TBNA and sent for pathological examination. Then all the clinical data were reviewed. Results 60 PCs （ pieces ） lymph node samples from different location were collected by TBNA. Pathological results showed l0 PCs malignant, 41 PCs benign, and 9 PCs unclear. The sensitivity, specificity, precision, positive and negative predictive value were 90.1%, 80.9%, 80.0%, 100% and 92,7% respectively. Good tolerance for all patients, no serious complications occurred. Conclusion For patients with suspected of lung cancer, TBNA is suggested to get pathologic results for lymph node staging identification regardless the diameters of the mediastinal lymph nodes. C-TBNA as a method of mediastinal lymph node pathological assessment has the advantage in minimal trauma, fewer complications, higher precision and lower cost, and shows safety, effectivity and feasibility in lung cancer staging application.