超声引导下支气管镜针吸活检在纵隔疾病中的诊断价值  

Value of endobronchial ultrasound-guided transbronchial needle aspiration in diagnosis of mediastinum lesions

作　　者：张茜茜[1] 马芸[1] 张晓菊[1] 安云霞[1] 陈卓昌[1] ZHANG Qian-qian;MA Yun;ZHANG Xiao-ju;AN Yun-xia;CHEN Zhuo-chang(Department of Respiratory and Critical Care Medicine,Henan Province People＇s Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]河南省人民医院呼吸及危重症科,河南郑州450003

出　　处：《临床肺科杂志》2018年第12期2226-2228,2276,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的评价超声引导下经支气管镜针吸活检(EBUS-TBNA)在纵隔病变中的诊断价值。方法回顾性分析2016年6月-2017年6月因影像学提示纵隔病变进行活检的患者104例,穿刺标本进行细胞学及组织病理学检查。结果 104例患者均顺利完成EBUS-TBNA,无并发症发生。81例穿刺阳性;恶性肿瘤60例(74. 1%),其中肺癌55例,其它肿瘤5例;良性疾病21例(25. 9%),其中结节病13例,结核8例。17例患者穿刺为阴性,最终经手术或临床随访证明6例患者为假阴性结果,6例患者的标本量不足。共有169个淋巴结进行针吸活检,最常见的淋巴结穿刺区位于7组与4组淋巴结,占所有标本量的34. 3%和30. 7%。EBUS-TBNA诊断的敏感性、特异性、阳性预测值及阴性预测值分别为86. 2%、100%、100%、43. 5%。结论EBUS-TBNA是诊断纵隔疾病安全、有效的方法。Objective To evaluate the diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration （EBUS-RBNA） for the mediastinum lesions. Methods 104 patients with mediastinum lesions on chest CT from June 2016 to June 2017 were evaluated for cytological and pathological examinations. Results No serious adverse events occurred. EBUS-TBNA was diagnostic in 81 patients, with diagnosis of malignancy in 60 patients （55 lung cancer,5 other carcinomas） and benign lesions in 17 patients （13 sarcoidosis and 8 tuberculosis）. Negative samples were 17 cases, and 6 cases were later diagnosed as false negative results by surgically proven or clinical follow-up. Inadequate specimens were obtained in 6 patients. In all patients, 169 biopsies from mediastinal lymph nodes were taken. The most common lymph node was in region 7 and 4, accounting for 34.3% and 30.7%. The sensitivity, specificity, and positive and negative predictive value of EBUS-TBNA for the diagnosis of mediastinal disease were 86.2%, 100%, 100% and 43.5% respectively. Conclusion EBUS-TBNA is a safe and reliable method for sampling mediastinal lesions.

关 键 词：超声支气管镜检查 活组织检查 针吸 纵隔疾病 

分 类 号：R564[医药卫生—呼吸系统]