Endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing mediastinal lymphadenectasis: a cohort study from a single center
Endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing mediastinal lymphadenectasis: a cohort study from a single center
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支气管内超声引导下经支气管针吸活检诊断纵隔淋巴结肿大：单中心队列研究
DOI：
10.1111/crj.12317
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发表时间：
2017-03-01
影响因子：
1.7
通讯作者：
Xu, Jin-fu
中科院分区：
文献类型：
--
作者：
Zhu, Jun;Zhang, Hai-ping;Xu, Jin-fu
目的超声引导下经支气管针吸（EBUS-TBNA）是临床诊断纵隔淋巴结肿大的常用方法。本研究旨在评价EBUS-TBNA在大型单中心纵隔淋巴结肿大的诊断意义。方法回顾性分析846例未明确诊断为纵隔淋巴结肿大的患者行EBUS-TBNA治疗的资料。结果842例患者成功行EBUS-TBNA手术。恶性肿瘤589例，其中鳞状癌118例（20.6%）、腺癌187例（32.7%）、小细胞癌88例（15.4%）。共有253例患者被诊断为良性疾病，包括结核病（111例，43.9%）和结节病（93例，36.7%）。肺癌、肺结核和结节病的诊断敏感性分别为94.4%、81.1%和51.6%。EBUS-TBNA的总灵敏度为92.0%。EBUS-TBNA诊断的肺癌患者N2期明显高于其他分期。短轴直径大于1cm的淋巴结靶向穿刺阳性率较高。结论EBUS-TBNA手术风险较小。纵隔淋巴结肿大合并的疾病以恶性疾病居多，良性疾病以肉芽肿性疾病为主。EBUS-TBNA对于诊断不明确的纵隔淋巴结肿大是一种有价值的诊断技术。
ObjectiveEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is commonly used for clinical diagnosis of mediastinal lymphadenectasis. This study aimed to evaluate the diagnostic significance of EBUS-TBNA for mediastinal lymphadenectasis in a large single center.MethodsA total of 846 patients who were not definitively diagnosed with mediastinal lymphadenectasis underwent EBUS-TBNA were retrospectively analyzed in this study.ResultsIn total, 842 patients underwent EBUS-TBNA successfully. There were 589 patients with malignancy, including squamous carcinoma (118 cases; 20.6%), adenocarcinoma (187 cases; 32.7%) and small cell carcinoma (88 cases; 15.4%). A total of 253 patients were diagnosed with benign disease, including tuberculosis (111 cases; 43.9%) and sarcoidosis (93 cases; 36.7%). The diagnostic sensitivity of lung cancer, tuberculosis and sarcoidosis were 94.4%, 81.1% and 51.6%, respectively. The overall sensitivity of EBUS-TBNA was 92.0%. N2 stage in lung cancer patients who were diagnosed by EBUS-TBNA was significantly higher than other stages. The positive rate of targeted puncture is high for the lymph nodes whose short-axis diameters were larger than 1cm.ConclusionThe operation risk of EBUS-TBNA is relatively small. In diseases complicated by mediastinal lymphadenectasis, malignant diseases are most, and benign diseases mainly are granulomatous. EBUS-TBNA is a valuable diagnostic technique in patients with mediastinal lymphadenectasis whose diagnosis have not been determined.