EBUS-TBNA细胞学检查对肺癌及结节病的诊断价值  

Value of EBUS-TBNA cytopathological detection in diagnosis of lung cancer and sarcoidosis

作　　者：韩非[1] 张俭[1] 孙加源[2] 陆慧萍[1] 韩宝惠[2] 张杰[1] 

机构地区：[1]上海交通大学附属胸科医院病理科,上海200030 [2]上海交通大学附属胸科医院肺内科,上海200030

出　　处：《上海交通大学学报（医学版）》2011年第12期1737-1740,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市级医院新兴前沿技术项目(SHDC12010101)~~

摘　　要：目的探讨经超声内镜引导下的经支气管针吸活检(EBUS-TBNA)细胞学检查对肺癌及结节病的诊断价值,并分析其临床病理特征。方法收集160例经EBUS-TBNA细胞学检查的病例,以组织病理学结合临床共同诊断为标准,分析细胞学检查在肺癌及结节病诊断中的价值。结果 150例病例经组织病理学诊断后确诊,其中肺癌108例,结节病23例,结核病4例,其他疾病15例。EBUS-TBNA细胞学检查显示肺癌95例,肺癌诊断阳性率88.0%(95/108),阴性率12.0%(13/108)。以组织病理学诊断为依据,EBUS-TBNA细胞学诊断肺癌的敏感度为88.0%,特异度为100%,阳性预测值为100%,阴性预测值为76.4%。EBUS-TBNA细胞学检查显示23例结节病中有15例可见非坏死肉芽肿病变,4例结核病中有1例可见干酪坏死的肉芽肿病变。结论 EBUS-TBNA细胞学检查对肺癌诊断的敏感度及特异度均较高,对结节病及结核病的诊断也有一定的提示作用。Objective To investigate the value of endobronchial ultrasound-guided transbronchial needle aspiration（EBUS-TBNA） cytopathological detection in diagnosis of lung cancer and sarcoidosis,and analyse the clinicopathological characteristics. MethodsOne hundred and sixty cases undergoing cytopathological detection were collected,and the value of cytopathological detection in the diagnosis of lung cancer and sarcoidosis was analysed based on the criteria of histologiopathology combined with clinical manifestations. ResultsThe diagnosis of 150 cases was confirmed by histopathological examinations,including 108 cases of lung cancer,23 cases of sarcoidosis,4 cases of tuberculosis and 15 cases of the other diseases.Ninety-five cases of lung cancer were detected by EBUS-TBNA cytopathological detection,with the positive diagnostic rate of 88.0%（95/108） and negative diagnostic rate of 12.0%（13/108）.The sensitivity,specificity,positive predictive value and negative predictive value of EBUS-TBNA cytopathological detection in diagnosis of lung cancer were 88.0%,100%,100% and 76.4% respectively.EBUS-TBNA cytopathological detection revealed 15 cases of non-caseous granuloma lesion among 23 cases of sarcoidosis,and 1 case of caseous granuloma in 4 cases of tuberculosis. ConclusionEBUS-TBNA cytopathology detection has high sensitivity and specificity in diagnosis of lung cancer,and may play a role in the diagnosis of sarcoidosis and tuberculosis.

关 键 词：经支气管针吸活检 肺癌 结节病 结核病 

分 类 号：R734.2[医药卫生—肿瘤] R446.8[医药卫生—临床医学]