Randomized controlled trial to evaluate the utility of suction and inner-stylet of EBUS-TBNA for mediastinal and hilar lymphadenopathy
Randomized controlled trial to evaluate the utility of suction and inner-stylet of EBUS-TBNA for mediastinal and hilar lymphadenopathy
复制标题
评估 EBUS-TBNA 抽吸和内管针治疗纵隔和肺门淋巴结肿大有效性的随机对照试验
DOI：
10.1186/s12890-018-0751-0
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发表时间：
2018-12-07
影响因子：
3.1
通讯作者：
Chen, Chengshui
中科院分区：
文献类型：
--
作者：
Lin, Xiaoxiao;Ye, Min;Chen, Chengshui
背景如何最大限度地提高支气管内超声引导下经支气管针吸活检（EBUS-TBNA）的诊断率和降低手术复杂性的最佳方法仍存在争议。我们进行了一项前瞻性随机对照试验，以确定最佳的程序EBUS-TBNA纵隔和肺门淋巴结肿大，特别注重的作用，inner-stylet和suction. MethodsConcretive患者扩大纵隔和肺门淋巴结（LNs），检测到计算机断层扫描（CT）或正电子发射断层扫描-CT（PET-CT），谁接受EBUS-TBNA。使用抽吸-管芯针、抽吸-无管芯针和管芯针-无抽吸程序，通过三次穿刺对每个LN进行采样。将样品涂抹在载玻片上进行细胞学评价。由一名设盲的细胞病理学家评价每组载玻片。主要结果是细胞学标本充足率和恶性淋巴结的诊断率。次要结果是组织核心收购率，手术时间，和出血量。ResultsThis研究评估了97例患者，共255 LN。LN最终诊断为良性144例，恶性104例，不充分7例。在标本充足率（分别为87.1%、88.2%、85.9%）或恶性肿瘤诊断率（分别为32.2%、31.8%、31.0%）方面，抽吸-探针组、抽吸-无探针组和探针-无抽吸组之间无显著差异。然而，使用吸引器与组织芯采集率的增加相关（P
BackgroundThe optimal procedure for maximizing the diagnostic yield and minimizing the procedural complexity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is controversial. We conducted a prospective randomized controlled trial to determine the optimal procedure of EBUS-TBNA for mediastinal and hilar lymphadenopathy, with a particular focus on the roles of the inner-stylet and suction.MethodsConsecutive patients with enlarged mediastinal and hilar lymph nodes (LNs), detected by computed tomography (CT) or positron emission tomography-CT (PET-CT), who underwent EBUS-TBNA were included. Each LN was sampled with three needle passes using suction-stylet, suction-no stylet, and stylet-no suction procedures. The samples were smeared onto glass slides for cytological evaluation. A single, blinded cytopathologist evaluated each set of slides. The primary outcomes were cytological specimen adequacy rate and diagnostic yield of malignant LNs. The secondary outcomes were tissue-core acquisition rate, procedural time, and the amount of bleeding.ResultsThis study evaluated 97 patients with a total of 255 LNs. The final LN diagnosis was benign in 144, malignant in 104, and inadequate in 7 cases. There were no significant differences among the suction-stylet, suction-no stylet, and stylet-no suction groups in specimen adequacy rate (87.1, 88.2, 85.9%, respectively) or diagnostic yield of malignancy (32.2, 31.8, 31.0%, respectively). However, the use of suction was associated with an increase in tissue-core acquisition rate (P