内镜超声检查在纵隔疾病和肺癌中的应用评价

Evaluation on the Application of Endoscopic Ultrasonography in Patients with Mediastinal Disease and Lung Cancer

目的 :评价内镜超声 (EUS)检查在纵隔疾病和肺癌中的应用价值。方法 :采用EUS检查胸腺瘤和肺癌各 1例并结合文献分析EUS在纵隔疾病和肺癌诊断中的作用及优缺点。结果 :1例胸腺瘤经EUS检查明确肿瘤的大小、发现肿块与浆膜粘连 ;1例肺癌行EUS检查 ,不仅了解了肿瘤的大小、转移淋巴结的数目 ,还明确了肿瘤与心脏、主动脉紧密粘连 ,因此 ,放弃手术 ,改用化疗。半年后复查 ,肿瘤明显缩小。说明EUS对纵隔病变和肺癌的定位、定性诊断具有很重要的作用 ,并可在EUS引导下经食管穿刺行淋巴结或肿瘤针吸活检进行肺癌诊断和分期。结论 :EUS是一项先进、安全。

Objective: To evaluate the clinical value of endoscopic ultrasonography (EUS) in patients with mediastinal diseases and lung cancer. Methods: One case of thymus tumor and one case of lung cancer were detected by EUS, and the effects and side-effects in diagnosing mediastinal disease and lung cancer by EUS were analyzed together with literature review. Results: The size of the tumor and its adhesion to serous membrane were detected by EUS in the case of thymus tumor. In the case of lung cancer, not only of the size of tumor and the number of metastalic lymph nodes were defined, but also its close adhesion to heart and aorta was demonstrated by EUS. According to these EUS results, chemotherapy was recommended instead of surgery. Re-examination after half a year showed the size of tumor had decreased significantly. These indicated that EUS was of great value in defining the nature and extensiveness of mediastinal diseases, also, a clinical grading-diagnosis of lung cancer can be achieved by transoesophageal puncture biopsy under the guide of EUS. Conclusion: EUS is an advanced, safe and helpful method in clinical diagnosis in mediastinal diseases and lung cancer.