程序性经支气管针吸活检联合快速现场评价技术在肺癌分期中的应用  

Application of programmed transbronchial needle aspiration combined with rapid on-site evaluation in lung cancer staging

作　　者：李娜 顾超 曹林峰 陶峰 陈文宇 LI Na;GU Chao;CAO Linfeng;TAO Feng;CHEN Wenyu(Department of Respiratory Medicine,the First Hospital of Jiaxing,Affiliated Hospital of Jiaxing University,Jiaxing 314000,China)

机构地区：[1]浙江省嘉兴市第一医院嘉兴学院附属医院呼吸内科,浙江嘉兴314000

出　　处：《中国现代医生》2022年第10期32-35,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2021RC031);浙江省嘉兴市科技计划项目(2019AD32256)。

摘　　要：目的 探讨程序性经支气管纵隔淋巴结针吸活检术(TBNA)联合快速现场评价技术(ROSE)对原发性肺癌胸内淋巴结行病理学评估及确定肺癌临床分期的应用价值。方法 收集2019年2月至2021年1月在浙江省嘉兴市第一医院呼吸内科被诊断为原发性肺癌伴有胸内淋巴结显示的患者61例,无论淋巴结大小均采用WANG氏定位法行程序性TBNA,收集标本进行ROSE及病理学检查,并分析患者的相关临床资料。结果 通过对61例患者行程序性TBNA检查,共穿刺淋巴结176个,病理结果明确为恶性病变95个,良性病变69个,12个淋巴结穿刺失败。在95个恶性病变中,有71个(74.74%)通过术中ROSE已发现恶性依据。134个短径在1.00 cm以上的淋巴结中,恶性病变89个,恶性率为66.42%。42个短径小于1.00 cm的淋巴结中,恶性病变6个,恶性率为14.29%。所有患者未发现严重并发症。结论 对于肺癌伴胸内淋巴结显示的患者,无论淋巴结直径大小均建议行程序性TBNA联合ROSE技术明确淋巴结性质。该技术安全、有效、价格低廉,适于在基层医院推广。Objective To investigate the application value of programmed transbronchial mediastinal lymph node needle aspiration(TBNA) combined with rapid on-site evaluation(ROSE) in pathologically evaluating intrathoracic lymph nodes in primary lung cancer and in determining the clinical stage of lung cancer. Methods Sixty-one patients with primary lung cancer accompanied by intrathoracic lymph node display diagnosed in the Department of Respiratory Medicine of the First Hospital of Jiaxing City in Zhejiang Province from February 2019 to January 2021 were collected.Regardless of lymph node size, programmed TBNA was performed using WANG’s localization method. Specimens were collected for ROSE and pathological examination, and the relevant clinical data of the patients were analyzed. Results A total of 176 lymph nodes were punctured by programmed TBNA in 61 patients. The pathological results showed 95malignant lymph node lesions, 69 benign lesions, and 12 failed lymph node punctures. Of the 95 malignant lesions, 71(74.74%) had been found to have a malignant basis by intraoperative ROSE. Of the 134 lymph nodes with a short diameter above 1.00 cm, 89 had malignant lesions, with a malignant probability of 66.42%. Of the 42 lymph nodes with a short diameter of less than 1.00 cm, 6 had malignant lesions, with a malignant probability of 14.29%. No serious complications were found in all patients. Conclusion Programmed TBNA combined with ROSE is recommended to identify the nature of lymph nodes in patients with lung cancer and intrathoracic lymph node display regardless of lymph node diameter. The technology is safe, effective, and cheap, which is suitable for promotion in primary hospitals.

关 键 词：肺癌 胸内淋巴结 分期 经支气管针吸活检术 快速现场评价技术 

分 类 号：R734.2[医药卫生—肿瘤]