超声引导下经支气管镜针吸活检对老年肺门和/或纵隔占位性病变患者的诊断价值及安全性研究  

Study on the diagnostic value and safety of endobronchial ultrasound-guided transbronchial needle aspiration in elderly patients with hilar and/or mediastinal masses

作　　者：王艳[1] 许小毛[1] 周为[1] 杨鹤[1] 田振莲[1] 陈岚[1] 陈起航[1] 柯会星[1] Wang Yan;Xu Xiaomao;Zhou Wei;Yang He;Tian Zhenlian;Chen Lan;Chen Qihang;Ke Huixing(Department of Respiratory and Critical Care Medicine,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Science,Beijing 100730,China)

机构地区：[1]北京医院呼吸与危重症医学科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2024年第4期438-443,共6页Chinese Journal of Geriatrics

摘　　要：目的评估超声引导下经支气管镜针吸活检(EBUS-TBNA)对老年人肺门和/或纵隔占位性病变的诊断价值和安全性。方法回顾性分析2015年6月至2023年3月北京医院呼吸与危重症医学科行EBUS-TBNA检查的肺门和/或纵隔占位性病变患者的临床资料,对比分析18~64岁组和≥65岁组患者一般情况、穿刺手术情况、术后病理结果,总结分析EBUS-TBNA手术的诊断价值及安全性。结果石研究共纳人362例患者,共计穿刺522组淋巴结、87组肺门/纵隔肿块,平均每位点经EBUS-TBNA穿刺(5.1±1.9)针,平均EBUS-TBNA操作时间为(20.1±1.8)min。18~64岁和≥65岁两组患者穿刺针数差异无统计学意义(χ^(2)=0.707、P=0.699)。18~64岁和≥65岁组两组患者并发症发生率差异无统计学意义[9.2%(14/152)比9.5%(20/210),χ^(2)=0.010、P=0.920]。362例患者经EBUS-TBNA检查共确诊恶性病变227例(62.7%)、良性病变126例(34.8%),另有9例(2.5%)患者通过经皮肺穿刺或外科手术后确诊恶性肿瘤。EBUS-TBNA诊断肺门和/或纵隔恶性病变的敏感性为96.2%(227/236),特异性为100.0%(126/126),其中18~64岁组诊断敏感性为95.1%(78/82)、≥65岁组为96.6%(140/145).两组患者EBUS-TBNA诊断敏感性差异无统计学意义(χ^(2)=0.281、P=0.596)。结论与18~64岁组患者相比,≥65岁组患者接受EBUS-TBNA手术的并发症发生率差异无统计学意义,EBUS-TBNA是老年肺门和/或纵隔占位性病变患者获得病理结果进而接受更进一步治疗的重要诊断手段,对提高老年肺门和/或纵隔占位性病变患者的诊治成功率有重要意义。Objective To assess the diagnostic value and safety of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)in elderly patients with hilar and/or mediastinal masses.Methods This study retrospectively analyzed the clinical data of patients with hilar and/or mediastinal lymphadenopathy who underwent EBUS-TBNA examination at the Department of Respiratory and Critical Care Medicine of Beijing Hospital from June 2015 to March 2023.The study compared and analyzed the general situation,puncture surgery,and postoperative pathological results of patients aged 18-64 and over 65.Furthermore,it summarized the diagnostic value and safety of EBUS-TBNA.Results The study included a total of 362 patients.The researchers performed a total of 522 punctures on groups of lymph nodes and 87 punctures on groups of hilar/mediastinal masses.On average,there were(5.1±1.9)EBUS-TBNA punctures per point.The average operating time was(20.1±1.8)minutes.There was no significant difference in the number of puncture needles used between the 18-64 year-old group and the≥65 year-old group(χ^(2)=0.707,P=0.699).Additionally,there was no statistically significant difference in the incidence of complications between the two groups[9.2%(14/152)vs.9.5%(20/210),χ^(2)=0.010,P=0.920].In the study,a total of 227 cases(62.7%)of malignant lesions and 126 cases(34.8%)of benign lesions were confirmed through EBUS-TBNA examination in 362 patients.Additionally,9 cases(2.5%)of patients were diagnosed with malignant tumors after undergoing percutaneous lung puncture or surgery.The sensitivity of EBUSTBNA in diagnosing malignant lesions in the hilar and/or mediastinum was found to be 96.2%(227/236),with a specificity of 100.0%(126/126).Furthermore,the diagnostic sensitivity of EBUS-TBNA was 95.1%(78/82)in the 18-64 year-old group and 96.6%(140/145)in the≥65 year-old group.Importantly,there was no statistically significant difference in EBUS-TBNA diagnostic sensitivity between the two patient groups(χ^(2)=0.281,P=0.596).Conclusions In pa

关 键 词：肺肿瘤 活组织检查 针吸 超声引导下经支气管镜针吸 肺门占位性病变 纵隔占位性病变 

分 类 号：R563[医药卫生—呼吸系统]