EBUS-TBNA在成人纵隔、肺门淋巴结肿块穿刺活检中的诊断价值  

Diagnostic value of EBUS-TBNA in adult mediastinal and hilar lymph node masses

作　　者：王毅[1] 于文军[2] 栾念旭[1] WANG Yi;YU Wen-jun;LUAN Nian-xu(Department of Respiration,Qingdao Municipal Hospital,Shandong,Qingdao 266011, China;Department of Oncology,the East Hospital District of Qingdao Municipal Hospital,Shandong,Qingdao 266011,China)

机构地区：[1]青岛市市立医院本部呼吸科,山东青岛266011 [2]青岛市市立医院东院区肿瘤科,山东青岛266011

出　　处：《中国医学前沿杂志（电子版）》2018年第10期131-134,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨超声引导下经支气管针吸活检(endobronchial ultrasound-guided transbronchial needle aspiration,EBUSTBNA)在成人纵隔、肺门淋巴结肿块穿刺活检中的临床诊断价值。方法收集2014年1月至2017年6月于青岛市市立医院本部住院治疗的100例纵隔、肺门淋巴结肿块患者的临床资料,记录患者穿刺淋巴结的位置分组、穿刺操作时间、淋巴结直径,计算灵敏度、特异度、阳性预测值及阴性预测值,比较不同直径淋巴结的诊断阳性率。结果 100例患者共穿刺182处淋巴结或肿块,主要包括4R组(72例)、7组(87例),平均操作时间为(20.4±1.8)分钟。87例诊断为恶性病变的患者中81例经EBUS-TBNA确诊,诊断的灵敏度、特异度、阳性预测值及阴性预测值分别为93.1%(81/87)、100.0%(13/13)、100.0%(81/81)及68.4%(13/19)。EBUS-TBNA对纵隔、肺门淋巴结肿块诊断的灵敏度和特异度分别为92.0%(92/100)、100.0%(8/8)。EBUS-TBNA对直径> 2 cm组淋巴结恶性病变的诊断阳性率显著高于其对直径≤2 cm组的诊断阳性率(P <0.05)。多数患者可耐受穿刺操作,操作过程中未发生纵隔大血管破裂出血、纵隔气肿、气胸等严重并发症。结论 EBUS-TBNA对纵隔、肺门淋巴结肿块具有良好的诊断准确度、灵敏度、特异度及安全性。Objective To evaluate the clinical value of endobronchial ultrasound-guided transbronchial needle aspiration(EBUSTBNA)in screening mediastinal and hilar lymphadenopathy.Method The clinical data of 100 patients with mediastinal and hilar lymph node masses in Qingdao Municipal Hospital were collected from January 2014 to June 2017,and the location group,the time of the puncture and the diameter of each lymph node were recorded,and the sensitivity,specificity,positive predictive value and negative predictive value were calculated,the positive rate of diagnosis of different diameter lymph nodes were compared.Result 182 lymph nodes or masses were punctured in 100 patients.There were 72 patients in group 4R and 87 patients in 7 groups.The average operation time was(20.4±1.8)min.In 87 patients with malignant lesions,81 were diagnosed by EBUS-TBNA.The sensitivity,specificity,positive predictive value and negative predictive value were 93.1%(81/87),100.0%(13/13),100.0%(81/81)and 68.4%(13/19),respectively.The sensitivity and specificity of EBUS-TBNA for mediastinal and hilar lymph node lesions were 92.0%(92/100)and 100.0%(8/8)respectively.The positive rate of EBUS-TBNA in the diagnosis of lymph node malignant lesions with diameter>2 cm was significantly higher than that of≤2 cm.Most patients can tolerate the puncture process.There were no serious complications such as bleeding,mediastinal emphysema and pneumothorax during operation.Conclusion EBUS-TBNA has good accuracy,sensitivity,specificity and safety in the diagnosis of mediastinal and hilar lymph node enlargement.

关 键 词：超声引导下经支气管针吸活检 纵隔淋巴结 肺门淋巴结 

分 类 号：R734[医药卫生—肿瘤]