现场细胞学在超声支气管镜引导下支气管针吸活检的应用价值  

Ultrasonic bronchoscopy guided rapid on-site cytologic evaluation of transbronchial needle aspiration biopsy

作　　者：庚俐莉[1] 刘春芳[1] 马海英[1] 陶晓峰[2] 任丽娜[1] 高娜[1] 王维学[3] 

机构地区：[1]大连医科大学附属大连市中心医院呼吸科,大连116033 [2]大连医科大学附属大连市中心医院病理科,大连116033 [3]大连医科大学附属大连市中心医院麻醉科,大连116033

出　　处：《中国肿瘤临床与康复》2017年第3期292-294,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨现场细胞学在超声支气管镜引导下支气管针吸活检的应用价值。方法选取2013年1月至2013年12月间大连医科大学附属大连市中心医院收治的经胸部计算机断层扫描显示肺部病变伴(或不伴)纵隔与肺门淋巴结肿大、肺门和(或)纵隔淋巴结肿大以及纵隔病变患者。随机选取33例患者行现场细胞学联合超声支气管镜引导下经支气管针吸活检。比较分析现场细胞学与组织学的诊断率。结果 33例患者穿刺均成功,穿刺阳性率达到100.0%。其中25例取得阳性组织学病理诊断,8例为非特异性诊断,阳性诊断率为75.8%。现场细胞学涂片可见异型细胞26例,阳性率达到78.8%。现场细胞学疑诊恶性肿瘤阳性率78.8%,后经组织学诊断恶性肿瘤阳性率为66.7%,现场细胞学疑诊恶性肿瘤与组织学诊断恶性肿瘤阳性率的比较,差异无统计学意义(P>0.05)。现场细胞学诊断无假阴性,存在假阳性,假阳性率为15.4%。结论超声支气管镜引导下支气管针吸活检联合现场细胞学不仅可以减少不必要的穿刺,缩短操作时间,而且经济简便。Objective To explore the application value of rapid on-site cytologic evaluation of transbronchial needle aspiration biopsy （TBNA） guided by uhrasonic bronchoscopy. Methods Clinical data was selected from patients with pulmonary disorders with or without complicated mediastinal and/or hilar lymphadenopathy and mediastinal disorders diagnosed bytransthoracic computed tomography （CT） scan. Thirty-three patients were randomly selected and underwent rapid on-site cytologic evaluation of transbron- chial needle aspiration biopsy between January 2013 and December 2013. Rate of diagnosis was compared between rapid on- site cytology and histology. Results All of the 33 cases of patients successfully completed biopsy puncture and the positive rate was 100. 0%. Among these patients, 25 patients underwent posi- tive pathological diagnosis and 8 patients underwent nonspecific diagnosis and the positive diagnosis rate was 75.8%. The abnormal cells were found in the rapid on-site cytologic smear in 26 patients and the positive rate was 78.8%. Positive rate of suspected malignant tumors detected by on-site cytology was 78. 8% and after the confirmed diagnosis by biopsy, the positive rate of malignant tumors was 66. 7% （P 〉 0. 05）. Rapid on-site cytology found non false negative and false positive existed and the false positive rate was 15.4%. Conclusions Ultrasonic bronchoscopy guided rapid on-site cytologic evaluation of transbronchial needle as- piration biopsy can reduce unnecessary puncture, shorten operation time and reduce the cost.

关 键 词：现场细胞学 超声支气管镜 支气管针吸活检 

分 类 号：R730.4[医药卫生—肿瘤]