支气管内超声引导针吸活检术在肺癌诊断中的应用价值  

The value of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA) in the diagnosis of lung cancer

作　　者：赵辉[1] 王俊[1] 李剑锋[1] 李运[1] 周足力[1] 卜梁[1] 隋锡朝[1] 杨帆[1] 刘彦国[1] 姜冠潮[1] 刘军[1] 

机构地区：[1]北京大学人民医院胸外科,北京100044

出　　处：《中国内镜杂志》2011年第2期124-127,共4页China Journal of Endoscopy

基　　金：首都医学发展科研基金资助(项目号:2009-3032)

摘　　要：目的探讨支气管内超声引导针吸活检术(EBUS-TBNA)在肺癌诊断中的应用价值。方法 2009年9月～2010年6月共56例影像学高度可疑肺癌患者,为明确诊断接受EBUS-TBNA。所有患者术前均接受了常规气管镜等检查,未能明确诊断。结果该组56例患者。其中,影像学怀疑肺癌伴纵隔淋巴结和(或)肺门淋巴结肿大(短径>1 cm)45例,经EBUS-TBNA行肿大淋巴结穿刺活检后确诊肺癌36例,9例EBUS-TBNA未能明确诊断者分别经胸腔镜或开胸手术确诊(肺癌3例,肺转移癌1例,肺部良性病变5例)。大气道旁肺实质内占位11例,经EBUS-TBNA检查后明确诊断肺癌9例,肺部炎症1例,1例EBUS-TBNA未能明确诊断,经胸腔镜手术证实为肺癌。EBUS-TBNA在肺癌诊断中的敏感性和准确性分别为91.8%(45/49)和92.9%(52/56)。所有患者检查耐受良好,无任何相关并发症发生。结论对于高度可疑肺癌的肺部肿物或肿大淋巴结,EBUS-TBNA具有很高的诊断价值,尤其是当其他诊断方法难以或无法明确诊断时,应考虑采用这一技术。【Objective】 To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration（EBUS-TBNA） in the diagnosis of lung cancer.【Methods】 A total of 56 patients who underwent EBUS-TBNA to diagnose radiologically highly suspected lung cancer between September 2009 and June 2010 was retrospectively reviewed.Conventional bronchoscopic biopsy before EBUSTBNA was non-diagnostic in all patients.【Results】 Of the 56 patients,45 patients were detected lung mass and enlarged mediastinal/hilar lymph nodes on radiographic examination of the chest（≥1.0 cm）,EBUS-TBNA was performed to obtain samples from mediastinal or hilar enlarged lymph nodes,36 cases were confirmed lung cancers,nine cases were diagnosed by other methods（3 lung cancer,1 metastatic lung tumor,and 5 benign cases）.11 patients with pulmonary masses located close to the central airways were accessed by EBUS-TBNA,lung cancer was confirmed in 9 cases,pneumonia in one.One case that was not confirmed by EBUS-TBNA was diagnosed lung cancer through thoracoscopic biopsy.The sensitivity and diagnostic accuracy of EBUS-TBNA in the diagnosis of lung cancer were 91.8%（45/49） and 92.9%（52/56）,respectively.The procedure was uneventful without complications.【Conclusions】 EBUS-TBNA targeting lymph nodes or masses highly suspicious for malignancy demonstrated high diagnostic value in the diagnosis of lung cancer.EBUS-TBNA is recommended for these cases,especially when other diagnostic methods have failed or are difficult.

关 键 词：支气管内超声 经支气管针吸活检 肺癌 诊断 

分 类 号：R734.2[医药卫生—肿瘤]