经超声支气管镜针吸活检在纵隔及肺门病变诊断中的应用价值  

Application value of ultrasound bronchoscopy needle aspiration biopsy in diagnosis of mediastinal and hilar lesions

作　　者：刘勇[1] 刘岩[1] 康贝贝 吕燕平[1] Liu Yong;Liu Yan;Kang Beibei;Lyu Yanping(Department of Respiratory,Zhoukou Central Hospital,Zhoukou 466100,China)

机构地区：[1]河南省周口市中心医院呼吸科,466100

出　　处：《中国实用医刊》2020年第16期18-20,共3页Chinese Journal of Practical Medicine

基　　金：2015年周口市科技攻关项目(15SF014)。

摘　　要：目的评价经超声支气管镜针吸活检(EBUS-TBNA)在纵隔/肺门病变诊断中的应用价值。方法抽取2017年2月1日至2019年8月31日在周口市中心医院就诊且符合入选标准的217例纵隔/肺门病变患者,均给予EBUS-TBNA,所获取标本送验细胞学及组织学病理诊断;对于诊断为非小细胞肺癌的部分患者行靶向基因检测(EGFR、KRAS基因突变;ALK和ROS1基因重排;MET基因扩增)。结果 217例接受EBUS-TBNA患者中,不合格穿刺29例(13.4%);138例(63.6%)被明确诊断为恶性病变;8例(3.7%)诊断为肉芽肿性疾病;穿刺标本合格但未能定性的患者,即EBUS-TBNA阴性患者共42例(19.4%),其经手术活检或临床随访(CT或PET扫描)明确诊断29例。EBUS-TBNA对于纵隔/肺门病变诊断的敏感性、特异性和诊断准确率分别为96%、100%和97%;阴性预测值为91%,阳性预测值为100%;在56个要求基因测试的非小细胞肺癌患者中,55个标本都有合适的肿瘤细胞成分用于基因突变分析。结论对于纵隔/肺门病变,EBUS-TBNA是一种安全、耐受性好、诊断率高的临床技术,且所取标本可以满足基因检测。Objective To evaluate the value of ultrasound bronchoscopy needle aspiration biopsy(EBUS-TBNA)in the diagnosis of mediastinal/hilar lesions.Methods A total of 217 patients with mediastinal/hilar lesions in Zhoukou Central Hospital who met the inclusion criteria from February 1,2017 to August 31,2019 were selected,they were given EBUS-TBNA.and the obtained specimens were for cytological and histological pathological diagnosis;for some patients diagnosed with non-small cell lung cancer,they were given targeted gene detection(EGFR,KRAS gene mutation;ALK and ROS1 gene rearrangement;MET gene amplification).Results Among the 217 patients receiving EBUS-TBNA,29 patients(13.4%)failed puncture;138 patients(63.6%)were definitely diagnosed as malignant lesions;8 cases(3.7%)were diagnosed with granulomatous disease;patients with qualified puncture specimens but unqualified,there were 42 patients(19.4%)with negative EBUS-TBNA,29 cases diagnosed by operation biopsy or clinical follow-up(CT or PET scan).The sensitivity,specificity and accuracy of EBUS-TBNA were 96%,100%and 97%,respectively.Of the 56 non-small cell lung cancer cases requiring genetic testing,55 specimens had appropriate tumor cell components for gene mutation analysis.Conclusions For mediastinal/hilar lesions,EBUS-TBNA is a safe,well-tolerated,and highly diagnostic clinical technique,and the specimens taken can meet the genetic testing.

关 键 词：超声支气管镜 针吸活检 纵隔病变 

分 类 号：R734[医药卫生—肿瘤]