经支气管针吸术在肺癌诊断中的作用  

The Role of Transbronchial Needle Aspiration in the Diagnosis of Lung Cancer

作　　者：蒋军红[1] 衡伟[1] 穆传勇[1] 郭凌川[2] 詹升华[2] 顾冬梅[2] 黄建安[1] 

机构地区：[1]苏州大学附属第一医院呼吸科,江苏苏州215006 [2]苏州大学附属第一医院病理科,江苏苏州215006

出　　处：《苏州大学学报（医学版）》2010年第6期1259-1261,I0012,共4页Suzhou University Journal of Medical Science

摘　　要：目的总结经支气管针吸术(TBNA)在肺癌诊断中的作用。方法分析61例支气管镜TBNA检查患者的临床资料。其中常规胸部CT检查提示有纵隔淋巴结肿大55例,支气管外压性狭窄6例。结果 61例中,确诊肺癌43例,结节病7例,结核3例,感染性淋巴结肿大8例。43例经TBNA获取标本病理确诊为肺癌36例(36/43,83.7%)。36例肺癌患者纵隔淋巴结穿刺62例次,穿刺成功50例次(50/62,80.6%);气管右前、隆突前、右主支气管前淋巴结共穿刺49次(49/62,78%)。其中20例周围型肺癌TBNA诊断阳性率70%(14/20),活检诊断阳性率14.3%(2/14),刷检诊断阳性率25%(5/20),肺泡灌洗诊断阳性率25%(2/8)。TBNA诊断准确率显著高于其他3种诊断方法(P<0.01)。结论对于周围型肺癌伴有纵隔淋巴结肿大及支气管外压性狭窄的患者,TBNA为更好的诊断方法。Objective To report the experiences with transbronchial needle aspiration（TBNA） in the diagnosis of lung cancer.Methods Sixty-one patients with medistinal lesion suspected lung cancer underwent TBNA and as evidenced by extrinsic compression on bronchoscopy were selected for TBNA.Results Malignancy was confirmed in 43 of the all 61 patients.7 patients diagnosed as sarcoidosis and 3 patients as tuberculosis.The other 8 patients diagnosed as non-malignant.TBNA successfully detected 36 of the 43（83.7%） histologically proven bronchial carcinomas.The 50 in 62（80.6%） of needle aspirations were successful in the total 36 patients.To 20 peripheral lung cancer patients,TBNA successfully detected 14 of the 20（70%） patients,biopsy detected 2 of the 20（14.3%） patients,brush biopsy detected 5 of the 20（25%） patients,and bronchoalveolar lavage fluid detected 2 of the 8（25%） patients.TBNA was a useful technique compared with the other sampling methods（P0.01）.Conclusion TBNA on selected patients suspected to have peripheral lung cancer based on medistinal lesionis is a safe and useful technique for diagnosis.

关 键 词：经支气管针吸术 支气管镜 肺癌 诊断 

分 类 号：R734.2[医药卫生—肿瘤]