CAJ | 학술논문

目的探讨支气管内超声引导针吸活检术(EBUS-TBNA)在明确邻近大气道肺内占位诊断中的应用价值.方法回顾性分析2009年9月至2011年9月,33例常规气管镜等检查未能明确诊断的影像学可疑肺癌患者,为明确肺内邻近大气道病变诊断接受EBUS-TBNA.对于经EBUS-TBNA检查后未能明确恶性诊断者,进一步接受胸腔镜或开胸手术确证.结果 33例经EBUS-TBNA检查后明确肺部恶性病变29例,其中非小细胞肺癌25例,小细胞肺癌4例；4例患者穿刺细胞及组织病理学检查无明确恶性证据,其中3例经电视胸腔镜或开胸手术证实为鳞癌,1例经胸腔镜手术证实为肺内炎性病变.本组EBUS-TBNA在大气道旁肺实质内占位中诊断的敏感性、特异性和准确性分别为90.2％、100.0％和90.9％,阳性预测价值和阴性预测价值分别为100％和25％.所有患者检查耐受良好,无任何相关并发症发生.结论对于邻近大气道临床可疑肺癌的肺内病变,EBUS-TBNA具有较高的诊断价值.
목적 탐토지기관내초성인도침흡활검술(EBUS-TBNA)재명학린근대기도폐내점위진단중적응용개치.방법 회고성분석2009년9월지2011년9월,33례상규기관경등검사미능명학진단적영상학가의폐암환자,위명학폐내린근대기도병변진단접수EBUS-TBNA.대우경EBUS-TBNA검사후미능명학악성진단자,진일보접수흉강경혹개흉수술학증.결과 33례경EBUS-TBNA검사후명학폐부악성병변29례,기중비소세포폐암25례,소세포폐암4례；4례환자천자세포급조직병이학검사무명학악성증거,기중3례경전시흉강경혹개흉수술증실위린암,1례경흉강경수술증실위폐내염성병변.본조EBUS-TBNA재대기도방폐실질내점위중진단적민감성、특이성화준학성분별위90.2％、100.0％화90.9％,양성예측개치화음성예측개치분별위100％화25％.소유환자검사내수량호,무임하상관병발증발생.결론 대우린근대기도림상가의폐암적폐내병변,EBUS-TBNA구유교고적진단개치.
Objective To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of intrapulmonary tumors located adjacent to the central airway.Methods The study was retrospective,from September 2009 to September 2011,33 patients with pulmonary masses located close to the central airways suspected to be lung cancer were accessed by EBUS-TBNA.Conventional bronchoscopic biopsy before EBUSTBNA was nondiagnostic in all cases.If EBUS-TBNA did not result in a formal pathological diagnosis of malignancy,patients were subsequently referred for a surgical procedure.Results Of the 33 patients,EBUS-TBNA confirmed lung cancer in 29 cases (4 small cell lung cancer,25 non-small cell lung cancer).Four patients were not confirmed by EBUS-TBNA,3 cases were diagnosed as squamous cell carcinoma by thoracoscoopy or thoracotomy,the other one was a pulmonary inflammatory lesion diagnosed by thoracoscopy.The sensitivity,specificity,accuracy,negative predictive value and positive predictive value of EBUS-TBNA for the diagnosis of intrapulmonary lesions was 90.2％,100％,90.9％,25％,and 100％,respectively.The procedure was uneventful,and there were no complications.Conclusion EBUS-TBNA is an effective tool with a high yield for the diagnosis of intrapulmonary lesions located adjacent to the central airway.