经支气管针吸活检在ⅢA-N2期非小细胞肺癌新辅助化疗纵隔再分期中的应用  

Role of transbronchial needle aspiration in mediastinal restaging of ⅢA-N2 non-small cell lung cancer after neoadjuvant chemotherapy

作　　者：周尧 庄志方[1] 姜敏炎[2] 薛志新[3] 仇铁峰[1] 朱小波[2] 凌夏君[1] 缪小辉[1] 蒋一雅[1] 钟亚花[1] 印秀丽[1] 周燕娟[1] 

机构地区：[1]江苏大学附属武进医院呼吸科,江苏常州213002 [2]江苏大学附属武进医院胸外科,江苏常州213002 [3]江苏大学附属武进医院病理科,江苏常州213002

出　　处：《江苏大学学报（医学版）》2013年第1期69-71,74,共4页Journal of Jiangsu University：Medicine Edition

基　　金：江苏大学临床医学科技发展基金资助项目(JLY20100027)

摘　　要：目的:探讨经支气管针吸活检(transbronchial needle aspiration,TBNA)在ⅢA-N2期非小细胞肺癌(non-smallcell lung cancer,NSCLC)新辅助化疗后纵隔再分期中的临床应用价值和安全性。方法:15例经TBNA证实的ⅢA-N2期NSCLC患者给予新辅助化疗后行TBNA再分期,所有患者行肺癌根治切除术及淋巴结清扫术分析TBNA在NSCLC新辅助化疗后纵隔再分期中的诊断敏感性、特异性、准确性、阳性预测值和阴性预测值。结果:TBNA活检的敏感性、特异性、准确性、阳性预测值和阴性预测值分别是80.6%、100%、87.2%、100%和72.7%。病理分型总符合率为80%。术前采用TBNA的c-N分期准确率达86.7%(13/15)。所有患者均未出现严重并发症。结论:经TBNA对NSCLC进行纵隔再分期准确率高,安全性高,具有一定的临床实用价值。Objective： To evaluate the clinical value and safety of transbronchial needle aspiration（TBNA） in mediastinal restaging of non-small cell lung cancer（NSCLC） after neoadjuvant chemotherapy.Methods： In 15 NSCLC patients with suspected N2 lymph node metastasis by chest CT scan,TBNA was performed for two times,before and after chemotherapy.The cytological results were compared with post-operative pathology.Results： Overall diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of TBNA in mediastinal restaging after neoadjuvant chemotherapy were 80.6%,100%,87.2%,100% and 72.7%.The overall coincidence rate of pathologic typing was 80%.The overall accuracy of c-N by TBNA was 86.7 %（13/15）.Serious complications were not observed in all patients.Conclusion： TBNA is an accurate and safe method for mediastinal restaging of NSCLC,which has certain clinical application value.

关 键 词：经支气管镜针吸活检 非小细胞肺癌 纵隔再分期 

分 类 号：R734.2[医药卫生—肿瘤]