Comparison of transbronchial needle aspiration with and without ultrasound guidance for diagnosing benign lymph node adenopathy
Comparison of transbronchial needle aspiration with and without ultrasound guidance for diagnosing benign lymph node adenopathy
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超声引导下经支气管针吸活检诊断良性淋巴结肿大的比较
DOI：
10.1186/s13000-020-00958-4
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发表时间：
2020-04
影响因子：
2.6
通讯作者：
Yang Xia
中科院分区：
文献类型：
--
作者：
Hui Shen;Lingyun Lou;Ting Chen;Yi Zou;Bin Wang;Zhihao Xu;Qin Ye;Huahao Shen;Wen Li;Yang Xia
背景经支气管针吸活检（TBNA）是一种用于诊断淋巴结（LN）肿大的微创手术。TBNA与支气管内超声（EBUS）的指导下，恶性淋巴结肿大的诊断率很高，但诊断良性淋巴结肿大的价值已经不太彻底investigated.MethodsWe回顾性评估了3540例纵隔淋巴结肿大谁收到TBNA。纳入166例良性纵隔淋巴结病患者，对293例淋巴结进行了活检。阳性结果定义为特异性组织学异常。比较了常规TBNA（cTBNA）和EBUS-TBNA，以及cTBNA和经支气管钳活检（TBFB）。结果EBUS-TBNA和cTBNA的诊断符合率分别为76. 84%和61. 31%（P<0. 05）。EBUS-TBNA对肉芽肿性（65.18%vs.45.45%，P < 0.05）和非肉芽肿性疾病（96.92%vs.84.06%，P < 0.05）的检出率均高于cTBNA（上级）。EBUS-TBNA对< 20 mm淋巴结的诊断率高于cTBNA（79.44%vs.64.29%，P < 0.05），但对> 20 mm淋巴结的诊断率差异不大。这些发现在接受cTBNA + EBUS-TBNA的一组独立患者中得到证实。cTBNA和TBFB之间的诊断率没有显着差异，但显着增加到76.67%，当两种models.ConclusionsEBUS-TBNA是良性纵隔LN疾病的首选微创诊断方法。当EBUS不可用时，联合cTBNA和TBFB是一种安全可行的替代方案。
BackgroundTransbronchial needle aspiration (TBNA) is a minimally invasive procedure performed to diagnose lymph node (LN) adenopathy. TBNA with and without endobronchial ultrasound (EBUS) guidance has a high diagnostic yield for malignant LN enlargement, but the value for diagnosing benign LN enlargement has been less thoroughly investigated.MethodsWe retrospectively evaluated 3540 patients with mediastinal LN enlargement who received TBNA. One hundred sixty-six patients with benign mediastinal lymphadenopathy were included and 293 LNs were biopsied. A positive result was defined as a specific histological abnormality. Conventional TBNA (cTBNA) and EBUS-TBNA, as well as cTBNA and transbronchial forceps biopsy (TBFB), were compared. The subgroup analysis was stratified by disease type and LN size.ResultsA diagnosis was made in 76.84% of the EBUS-TBNA and 61.31% of the cTBNA (P< 0.05). EBUS-TBNA was superior to cTBNA for both granulomatous (65.18% vs. 45.45%,P< 0.05) and non-granulomatous disease (96.92% vs. 84.06%,P< 0.05). In contrast, the diagnostic yield of EBUS-TBNA was higher than that of cTBNA for LNs < 20 mm (79.44% vs. 64.29%,P< 0.05), but for LNs > 20 mm the difference was marginal. These findings were confirmed in a group of independent patients who received cTBNA plus EBUS-TBNA. The diagnostic yield did not differ between cTBNA and TBFB, but significantly increased to 76.67% when both modalities were employed.ConclusionsEBUS-TBNA is the preferred minimally invasive diagnostic method for benign mediastinal LN disease. Combined cTBNA and TBFB is a safe and feasible alternative when EBUS is unavailable.
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影响因子：
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