中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
8期
528-531
,共4页
胡洁%苏永华%殷霞%洪群英%李春%叶茂松%李菁%胡沁%石园%白春学%张新
鬍潔%囌永華%慇霞%洪群英%李春%葉茂鬆%李菁%鬍沁%石園%白春學%張新
호길%소영화%은하%홍군영%리춘%협무송%리정%호심%석완%백춘학%장신
支气管镜检查%腔内超声检查%活组织检查,针吸%肺门%纵隔
支氣管鏡檢查%腔內超聲檢查%活組織檢查,針吸%肺門%縱隔
지기관경검사%강내초성검사%활조직검사,침흡%폐문%종격
Bronchoscopy%Endosonography%Biopsy,needle%Hilum of lung%Mediastinum
目的 探讨超声内镜引导下经支气管针吸活检(EBUS-TBNA)对经传统方法检查不能明确病因的肺门及纵隔占位性病变的诊断价值.方法 收集2009年9月至2011年3月在中山医院就诊的纵隔和(或)肺门占位性病变患者91例,行EBUS-TBNA检查,对病理结果与诊断符合率进行对比分析.结果 91例均顺利完成EBUS-TBNA,其中恶性肿瘤61例,敏感度为91.7％,特异度为100％,诊断符合率为91.8％；良性病变30例,其诊断符合率为60.0％.获取组织条标本者,具有较完整病理组织结构的比例为36.9％(24/65).对良性病变和全部病例,细胞学联合组织病理检查诊断符合率明显高于单纯细胞学检查(P＜0.01),对恶性病变,联合检测诊断符合率较单纯细胞学检测有增高趋势,但差异无统计学意义(P＞0.05).结论 EBUS-TBNA诊断病因不明的肺门及纵隔占位性病变安全、有效,对良、恶性病变的诊断价值不同.
目的 探討超聲內鏡引導下經支氣管針吸活檢(EBUS-TBNA)對經傳統方法檢查不能明確病因的肺門及縱隔佔位性病變的診斷價值.方法 收集2009年9月至2011年3月在中山醫院就診的縱隔和(或)肺門佔位性病變患者91例,行EBUS-TBNA檢查,對病理結果與診斷符閤率進行對比分析.結果 91例均順利完成EBUS-TBNA,其中噁性腫瘤61例,敏感度為91.7％,特異度為100％,診斷符閤率為91.8％；良性病變30例,其診斷符閤率為60.0％.穫取組織條標本者,具有較完整病理組織結構的比例為36.9％(24/65).對良性病變和全部病例,細胞學聯閤組織病理檢查診斷符閤率明顯高于單純細胞學檢查(P＜0.01),對噁性病變,聯閤檢測診斷符閤率較單純細胞學檢測有增高趨勢,但差異無統計學意義(P＞0.05).結論 EBUS-TBNA診斷病因不明的肺門及縱隔佔位性病變安全、有效,對良、噁性病變的診斷價值不同.
목적 탐토초성내경인도하경지기관침흡활검(EBUS-TBNA)대경전통방법검사불능명학병인적폐문급종격점위성병변적진단개치.방법 수집2009년9월지2011년3월재중산의원취진적종격화(혹)폐문점위성병변환자91례,행EBUS-TBNA검사,대병리결과여진단부합솔진행대비분석.결과 91례균순리완성EBUS-TBNA,기중악성종류61례,민감도위91.7％,특이도위100％,진단부합솔위91.8％；량성병변30례,기진단부합솔위60.0％.획취조직조표본자,구유교완정병리조직결구적비례위36.9％(24/65).대량성병변화전부병례,세포학연합조직병리검사진단부합솔명현고우단순세포학검사(P＜0.01),대악성병변,연합검측진단부합솔교단순세포학검측유증고추세,단차이무통계학의의(P＞0.05).결론 EBUS-TBNA진단병인불명적폐문급종격점위성병변안전、유효,대량、악성병변적진단개치불동.
Objective To explore the diagnostic values of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the patients with hilar and mediastinal masses.Methods A total of 91 patients with mediastinal/hilar masses undergoing EBUS-TBNA in Zhongshan Hospital between September 2009 and March 2011 were retrospectively enrolled.Their unknown etiologies were difficult to be assessed by a traditional biopsy.The association of pathologic examinations and clinical data were analyzed.Results Among them,61 patients had malignant lesions while 30 patients were diagnosed with benign diseases.In the cases with malignant lesions,the diagnostic sensitivity,specificity and accordance rate were 91.67％,100％ and 91.80％ respectively.The diagnostic accordance rate of benign lesions was 60％.And 36.9％ (24/65) of the samples were small-sized so as to improve the diagnostic accuracy.The combination of cytology and histology significantly increased the diagnostic accordance versus cytology alone in all cases (P ＜0.01 ). But there was no statistically significant difference in the malignant lesion subgroup with a better tendency (P ＞ 0.05 ). No severe complication occurred. Conclusion With a high diagnostic accuracy and a low complication rate for the patients with hilar and mediastinal masses of unknown etiologies,EBUS-TBNA has different values for diagnosing malignant and benign lesions.
