超声内镜引导下经支气管针吸活组织检查术在小细胞肺癌中的诊断价值  

Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in small cell lung cancer

作　　者：洪芳芳[1] 王杰[1] 鲍彰[1] 周建英[1] 

机构地区：[1]浙江大学医学院附属第一医院呼吸内科,浙江杭州310003

出　　处：《上海医学》2015年第2期143-146,I0004,共5页Shanghai Medical Journal

基　　金：浙江省科技专项重大社会发展项目(2012C13022-2);中西医结合老年呼吸病学项目(2012-XK-A18)资助

摘　　要：目的探讨超声内镜引导下经支气管针吸活组织检查术(EBUS-TBNA)在小细胞肺癌(SCLC)中的诊断价值。方法回顾性分析2013年1月—2014年5月胸部CT检查显示肺内肿块和(或)纵隔-肺门淋巴结肿大且行EBUS-TBNA的354例患者的临床资料,分析EBUS-TBNA在SCLC中的诊断价值。结果最终明确诊断SCLC 49例,其中经EBUS-TBNA明确诊断为SCLC 46例,诊断阳性率为93.9%。经细胞学检查明确诊断4例,诊断阳性率为8.2%(4/49);经组织病理学明确诊断30例,诊断阳性率为61.2%(30/49);余12例经细胞学和组织病理学检查均为阴性的患者经免疫组织化学法明确诊断。结论 EBUS-TBNA在SCLC中的诊断阳性率较高。EBUS-TBNA既可作为SCLC诊断的首选检查,也可作为其他检查失败后的有效补充。Objcotive To explore the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration （EBUS-TBNA） in small cell lung cancer （SOLO）. Methods A retrospective study was done in 354 patients who underwent EBUS-TBNA in our hospital between January 2013 and May 2014. The patients suffered from thoracic masses and/or mediastinal-hilar lymphoadenopathy proved by OT scan. The value of EBUSTBNA in diagnosis of SOLO was assessed. Results A total of 49 patients had a final diagnosis of SOLC. The overall diagnostic yield of EBUS-TBNA for SCLC was 93.9% （46/49）. Of them, 4 cases were diagnosed by cytology and the positive rate was 8.2% ; 30 cases were diagnosed by histological H-E staining, and the positive rate was 61.2 %. The remaining 12 cases whose cytological and histopathological results were all negative were diagnosed by immunohistochemistry. Conclusion EBUS-TBNA has a high diagnostic yield in SOLO. It can be recommended for patients suspected of SOLO, even when other diagnostic tests have failed.

关 键 词：超声内镜引导下经支气管针吸活组织检查术 细胞学 组织学 免疫组织化学法 小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]