EBUS-TBNA标本检测荧光定量TB-PCR对纵隔淋巴结核的诊断价值  

Diagnostic value of fluorescence quantitative TB-PCR for mediastinal lymphadenopathy in EBUS-TBNA specimens

作　　者：张红军 杨巧娟 张海涛 苏蔚 谢永宏 金发光 顾兴 Zhang Hongjun;Yang Qiaojuan;Zhang Haitao;Su Wei;Xie Yonghong;Jin Faguang;Gu Xing(Department of Pulmonary and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi′an, 710038, China;Department of Endocrinology, Liqun Hospital, Putuo District, Shanghai, 200333, China)

机构地区：[1]空军(第四)军医大学第二附属医院呼吸与危重症医学科,西安710038 [2]上海市普陀区利群医院内分泌科,上海200333

出　　处：《中华肺部疾病杂志（电子版）》2020年第2期159-163,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家公益性行业科研专项(201402024)。

摘　　要：目的研究荧光定量TB-PCR法检测超声支气管镜引导下经支气管透壁针吸活检(EBUS-TBNA)标本的临床应用价值。方法对2017年01月至2018年06月在我院呼吸内镜中心接受EBUS-TBNA检测的65例患者的临床资料进行回顾性分析,比较病理检查和病理检查联合荧光定量TB-PCR检测法对临床诊断纵膈淋巴结结核的敏感性、特异性和准确性。结果病理检查对纵膈淋巴结核的敏感性、特异性、准确性分别是75%、83.3%、78.9%,而荧光定量TB-PCR法联合病理学检查对纵膈淋巴结核诊断的敏感性、特异性、准确率分别为90.5%、100%、94.4%。结论针对EBUS-TBNA标本,采用病理学检查联合荧光定量TB-PCR检测法能够明显提高诊断淋巴结结核的敏感性、特异性、准确性,有利于结节病和纵隔结核、非结核分枝杆菌病的鉴别,具有很高的临床应用价值。Objective To evaluate the clinical value of fluorescence quantitative tuberculosis-polymerase chain reaction(TB-PCR)for mediastinal lymphadenopathy in endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)specimens.Methods The clinical data of 65 patients who received EBUS-TBNA in the Respiratory Endoscopy Center of Tangdu Hospital affiliated to Air Force Military Medical University from January 2017 to June 2018 were retrospectively analyzed.The sensitivity,specificity and diagnostic accuracy of the pathological examination of biopsy specimens for lymph node tuberculosis with or without fluorescence quantitative TB-PCR were statistically analyzed.Results The sensitivity,specificity,and accuracy of EBUS-TBNA specimens by the pathological examination for the diagnosis of mediastinal lymphatic tuberculosis were 75%,83.3%,and 78.9%,respectively,while they were 90.5%,100%,and 94.4%,respectively,by the fluorescence quantitative TB-PCR combined with pathological examination.Conclusion The pathologic diagnosis of EBUS-TBNA specimens combined with fluorescence quantitative TB-PCR is significantly improved in the sensitivity,specificity and accuracy for the diagnosis of lymph node tuberculosis,which is helpful in the differentiation of sarcoidosis and mediastinal tuberculosis and non-tuberculous mycosis,and therefore,it is worthy of clinical application.

关 键 词：EBUS-TBNA TB-PCR 纵隔淋巴结核 诊断 

分 类 号：R563[医药卫生—呼吸系统] R734.2[医药卫生—内科学]