经支气管内超声引导针吸活检术在小细胞肺癌与非小细胞肺癌诊断中的应用价值  

Diagnostic Value of Transbronchial Ultrasound-guided Needle Aspiration Biopsy in the Diagnosis of Small Cell Lung Cancer and Non-small Cell Lung Cancer

作　　者：谭晓刚[1] 刘宝东[1] 王若天[1] 张毅[1] Xiaogang TAN;Baodong LIU;Ruotian WANG;Yi ZHANG(Department of Thoracic Surgery,Xuan Wu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院胸外科,北京100053

出　　处：《中国肺癌杂志》2020年第6期466-471,共6页Chinese Journal of Lung Cancer

基　　金：首都医科大学科研培育(校自然)基金(No.PYZ2017152);北京市医管局“扬帆”计划临床技术创新项目(No.XMLX201701)资助。

摘　　要：背景与目的纤维支气管镜腔内超声引导针吸活检术(endobronchial ultrasound guided transbronchial needle aspiration,EBUS-TBNA)作为近年来发展的新技术,具有操作简单、创伤小、准确率和安全性高及可重复性等优点,已成为进行肺癌诊断和纵隔分期的新标准。由于小细胞肺癌(small cell lung cancer,SCLC)和非小细胞肺癌(non-small cell lung cancer,NSCLC)的生物学特性以及治疗方案的不同,因此,在早期能诊断并鉴别的病理类型,对于肺癌的分期、治疗及预后均有很重要意义。本文探讨EBUS-TBNA在诊断SCLC和NSCLC中的准确率及敏感性。方法回顾性分析2012年1月-2018年12月首都医科大学宣武医院胸外科进行142例经支气管内超声引导针吸活检术患者的临床资料,选取最终确诊85例SCLC和NSCLC患者,比较两组差异。结果最终经免疫组化病理明确SCLC 45例,其中经EBUS-TBNA明确诊断为SCLC 42例,诊断准确率、敏感度分别为93.3%(42/45)、100.0%(42/42)。经细胞学检查明确诊断22例,诊断准确率为48.9%(22/45);经病理明确诊断NSCLC 40例,其中经EBUS-TBNA明确诊断为NSCLC 35例,诊断准确率、敏感度分别为87.5%(35/40)、100.0%(35/35)。经细胞学检查明确诊断11例,诊断准确率为27.5%(11/40);EBUS-TBNA在SCLC组的诊断准确率明显高于NSCLC组,且有统计学意义(P<0.05)。结论EBUS-TBNA用于诊断SCLC较NSCLC的准确率高。EBUS-TBNA作为微创技术,可协助SCLC早期诊断,及时治疗。Background and objective As a new technique developed in recent years,endobronchial ultrasound guided transbronchial needle aspiration(EBUS-TBNA)has the advantages of simple operation,minimal invasive,high accu-racy,safety and repeatability.It has become a new standard for lung cancer diagnosis and mediastinal staging.Because small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC)have different biological characteristics and treatment methods,it is very important to diagnose and differentiate the types of lung cancer in the early stage of lung cancer for the staging,treat-ment and prognosis of lung cancer.This article evaluated the accuracy and sensitivity of EBUS-TBNA in the diagnosis of SCLC and NSCLC.Methods From January 2012 to December 2018,the clinical data of 85 patients with SCLC and NSCLC who performed EBUS-TBNA in Xuan Wu Hospital CMU were retrospectively analyzed and the differences between the two groups were compared.Results 45 cases of SCLC were confirmed by immunohistochemistry and pathology.42 cases of SCLC were diagnosed by EBUS-TBNA.The accuracy and sensitivity of diagnosis were 93.3%(42/45)and 100.0%(42/42),respectively.The positive rate of diagnosis was 48.9%(22/45)in 22 cases diagnosed by cytology,and 40 cases diagnosed by pathology,including 35 cases diagnosed by EBUS-TBNA.The accuracy and sensitivity of diagnosis were 87.5%(35/40)and 100.0%(35/35),respectively.The positive rate of diagnosis was 27.5%(11/40)in 11 cases diagnosed by cytology.The diagnostic sensitivity of EBUS-TBNA in SCLC group was significantly higher than that in NSCLC group(P<0.05).Conclusion EBUSTBNA is more sensitive in the diagnosis of SCLC than NSCLC.As a minimally invasive technique,EBUS-TBNA can assist SCLC in early diagnosis and timely treatment.

关 键 词：经支气管内超声引导针吸活检术 小细胞肺癌 肺肿瘤 诊断准确率 

分 类 号：R734.2[医药卫生—肿瘤]