CAJ | 학술논문

目的初步探讨内镜超声引导下细针穿刺抽吸术(EUS-FNA)在纵隔肿大淋巴结、纵隔不明原因占位定性诊断及肺癌N分期中的应用价值.方法应用22 G穿刺针对61例患者经食管行EUS.FNA,穿刺物均行病理及细胞学检查.结果 EUS·FNA诊断阳性率为93.4%(57/61),细胞学及病理诊断阳性率分别为85.2%(52/61)和83.6%(51/61).100.0%(26/26)临床疑诊肺癌纵隔淋巴结转移而经支气管镜等检查未能提供病理或细胞学证据者均通过EUS-FNA得到诊断,其中21例诊断为肺癌、5例排除肺癌诊断为良性疾病;86.4%(19/22)纵隔不明原因占位明确定性;85.7%(6/7)有恶性肿瘤病史影像学检查疑诊纵隔淋巴结转移者,EUS-FNA病理及细胞学结果支持转移;6例经支气管镜检查已获得明确病理细胞学诊断的肺癌病例但影像学提示纵隔淋巴结肿大,为明确N分期行EUS-FNA,结果均为阳性,改变了原计划治疗方案.本组无一例EUS-FNA相关并发症发生.结论对于明确纵隔肿大淋巴结、纵隔不明原因占位定性诊断及肺癌N分期,EUS-FNA是一种较为安全、有效的诊断方法.
목적 초보탐토내경초성인도하세침천자추흡술(EUS-FNA)재종격종대림파결、종격불명원인점위정성진단급폐암N분기중적응용개치.방법 응용22 G천자침대61례환자경식관행EUS.FNA,천자물균행병리급세포학검사.결과 EUS·FNA진단양성솔위93.4%(57/61),세포학급병리진단양성솔분별위85.2%(52/61)화83.6%(51/61).100.0%(26/26)림상의진폐암종격림파결전이이경지기관경등검사미능제공병리혹세포학증거자균통과EUS-FNA득도진단,기중21례진단위폐암、5례배제폐암진단위량성질병;86.4%(19/22)종격불명원인점위명학정성;85.7%(6/7)유악성종류병사영상학검사의진종격림파결전이자,EUS-FNA병리급세포학결과 지지전이;6례경지기관경검사이획득명학병리세포학진단적폐암병례단영상학제시종격림파결종대,위명학N분기행EUS-FNA,결과 균위양성,개변료원계화치료방안.본조무일례EUS-FNA상관병발증발생.결론 대우명학종격종대림파결、종격불명원인점위정성진단급폐암N분기,EUS-FNA시일충교위안전、유효적진단방법.
Objective To evaluate the efficacy of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) in diagnosis of enlarged mediastinal lymph nodes (LNs), mediastinal occupying lesion of unknown origin, as well as in N-staging for lung cancer. Methods EUS-FNA was performed via esophagus with a 22-gange needle in 61 patients, followed by pathological and cytological examinations. Results The positive diagnosis rate of EUS-FNA was 93.4% (57/61), and the cytological and pathological diagnostic accuracy were 85.2% (52/61) and 83.6% (51/61), respectively. Of 61 patients, 26 were suspected as having lung cancer with mediastinal lymph nodes metastasis, but the bronchoscopy failed to confirm the diag-nosis. EUS-FNA diagnosed lung cancer in 21 and benign lesion in 5. Of 22 patients with mediastinal occupying lesions of unknown origin, 19 (86.4%) were diagnosed by EUS-FNA. Of 7 patients with malignant tumor history and enlarged mediastinal lymph nodes, EUS-FNA confirmed mediastinal metastasis in 6 (85.7%). Six cases of lung cancer with suspected mediastinal lymph nodes metastasis were confirmed by EUS-FNA and the corresponding therapy regimen was modified. No complications related to EUS-FNA procedure occurred. Conclusion EUS-FNA is a safe and effective method for diagnosis of enlarged medistinal LNs, mediastinal lesion of unkown origin and N-stage of lung cancer.