EBUS-TBNA联合ROSE对肺门纵隔疾病的诊断价值  

Diagnostic Value of EBUS-TBNA Combined with ROSE in Hilar and Mediastinal Diseases

作　　者：严正平 YAN Zhengping(Department of Respiratory and Critical Care Medicine,Zhangjiagang Hospital of Traditional Chinese Medicine,Zhangjiagang Jiangsu 215600,China)

机构地区：[1]张家港市中医医院呼吸与危重症医学科,江苏张家港215600

出　　处：《中国医疗设备》2023年第2期137-142,共6页China Medical Devices

基　　金：张家港市卫计系统青年科技项目(ZJGQNKJ201929)。

摘　　要：目的探讨经气管镜超声引导针吸活检(Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration,EBUSTBNA)联合快速现场细胞学评价(Cytological Rapid On-Site Evaluation,C-ROSE)对肺门纵隔疾病的诊断价值。方法回顾性收集2016年3月至2020年1月于我院就诊的127例肺门或纵隔淋巴结肿大患者的临床资料,其中仅行EBUS-TBNA者52例,记为非C-ROSE组,行EBUS-TBNA联合C-ROSE者75例,记为C-ROSE组。分析患者的一般资料、EBUS-TBNA情况、穿刺标本合格率、并发症情况、最终诊断结果、对肺癌的诊断价值以及一致性。结果非C-ROSE组穿刺标本合格率为90.38%,C-ROSE组为98.67%,差异有统计学意义(χ^(2)=4.680,P=0.031)。非C-ROSE组并发症总发生率为11.54%,C-ROSE组为1.33%,差异有统计学意义(χ^(2)=6.141,P=0.013)。C-ROSE组的诊断率(90.67%)、敏感度(95.71%)及准确度(96.00%)均高于非C-ROSE组(71.15%、82.22%、84.62%),差异有统计学意义(χ^(2)=8.164、5.764、5.031,P=0.004、0.016、0.025)。C-ROSE组Kappa系数0.749(95%CI:0.479~1.019),与最终诊断结果的一致性较强(P<0.001)。结论EBUS-TBNA联合ROSE诊断肺门纵隔淋巴肿大,可提高穿刺标本质量、减少并发症,提高诊断率、敏感度以及准确度。Objective To explore the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)combined with cytological rapid on-site evaluation(C-ROSE)for hilar and mediastinal disease.Methods Clinical data of 127 patients with hilar or mediastinal lymphadenopathy admitted to our hospital from March 2016 to January 2020 were collected retrospectively.Among them,52 patients who received EBUS-TBNA only were recorded as non-C-ROSE group,and 75 patients who received EBUS-TBNA combined with C-ROSE were recorded as C-ROSE group.The general information,EBUS-TBNA,qualified rate of puncture specimens,complications,final diagnosis results,diagnostic value and consistency of lung cancer were analyzed.Results The qualified rate of puncture specimens in non-C-ROSE group and C-ROSE group was 90.38%and 98.67%respectively,with statistically significant difference(χ^(2)=4.680,P=0.031).The total complication rate was 11.54%in the non-C-ROSE group and 1.33%in the C-ROSE group,and the difference was statistically significant(χ^(2)=6.141,P=0.013).The diagnostic rate(90.67%),sensitivity(95.71%)and accuracy(96.00%)of the C-ROSE group were all higher than those of the non-C-ROSE group(71.15%,82.22%,84.62%),and the differences were statistically significant(χ^(2)=8.164,5.764,5.031;P=0.004,0.016,0.025).In the C-ROSE group,Kappa coefficient was 0.749(95%CI:0.479-1.019),which was highly consistent with the final diagnosis(P<0.001).Conclusion EBUS-TBNA combined with ROSE in the diagnosis of hilar mediastinal lymphadenopathy can improve the quality of puncture specimens,reduce complications,and improve the diagnostic rate,sensitivity and accuracy.

关 键 词：经气管镜超声引导针吸活检 快速现场细胞学评价 肺门纵隔疾病 穿刺标本 

分 类 号：R563[医药卫生—呼吸系统]