超声内镜引导下针吸活检诊断肺癌及纵隔淋巴结转移

Endoscopic ultrasonography guided fine-needle aspiration in diagnosis of lung neoplasm and mediastinal lymph node metastasis

目的 探讨超声内镜引导下的针吸活检术 (EUS FNA)诊断肺癌及纵隔淋巴结转移的可行性、准确性和安全性。 方法 应用PentaxFG32 UA超声内镜及直径为 0 8mm的GIP穿刺针(Medi Globe) ,对 10例患者 (6例肺部肿块伴纵隔淋巴结肿大 ,1例右肺肿块 ,1例食管旁肿块 ,2例纵隔淋巴结广泛肿大 )行EUS FNA。 结果 1例患者未能取得足够的标本 ;EUS FNA诊断为恶性肿瘤者7例 (小细胞癌 5例 ,鳞癌、腺癌各 1例 ,均经随诊确诊 ) ,良性病变者 2例 (分别经胸腔镜或纵隔镜及随诊确诊 )。未出现任何与穿刺相关的并发症。 结论 EUS FNA在肺癌及纵隔淋巴结转移的诊断中是一准确、安全、实用的检查方法。

Objective To access the feasibility, safety and accuracy of endoscopic ultrasonography guided fine needle aspiration (EUS FNA) in patients with suspected lung neoplasm and metastatic mediastinal lymph nodes. Methods Using a linear array scanning endosonography (Pentax FG32 UA) and a 22 guage GIP (Medi Globe) needle,we performed EUS FNA in 10 patients including 6 patients with lung mass and enlarged mediastinal lymph nodes, 1 patient with a mass in the right lung, 1 patient with a mass near the esophagus, and 2 patients with extensive enlarged mediastinal lymph nodes. The data collected included lesions types, complications and diagnostic accuracy. Results EUS FNA revealed small cell carcinoma in 5 patients, squamous cell carcinoma in 1, adenocarcinoma in 1, and benign lymph nodes in 2. Malignancy was confirmed by follow up in 7 patients, and benign tumor was confirmed by mediastinoscopy, thoracoscopy or follow up in 2 patients. In 1 patient, FNA sample was not diagnosed because of inadequate specimen. None of the patients had complications caused by any procedures. Conclusion EUS FNA is safe, reliable and accurate in diagnosis of suspicious lung neoplasm and mediastinal lymph node.