中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2010年
10期
738-741
,共4页
孙加源%韩宝惠%赵珩%张俭%冯久贤%张杰%沙慧芳%戚大江%顾爱琴%沈洁%冯运
孫加源%韓寶惠%趙珩%張儉%馮久賢%張傑%沙慧芳%慼大江%顧愛琴%瀋潔%馮運
손가원%한보혜%조형%장검%풍구현%장걸%사혜방%척대강%고애금%침길%풍운
支气管镜检查%超声检查,介入性%肺肿瘤
支氣管鏡檢查%超聲檢查,介入性%肺腫瘤
지기관경검사%초성검사,개입성%폐종류
Bronchoscopy%Ultrasonography,interventional%Lung neoplasms
目的 评价超声支气管镜引导下的经支气管针吸活检(EBUS-TBNA)对纵隔和肺门淋巴结肿大和肺内肿块的诊断价值和安全性.方法 对2009年7月至2010年1月上海市肺科医院胸部CT检查显示胸腔内肿物和(或)纵隔-肺门淋巴结肿大的门诊或住院患者行EBUS-TBNA,观察诊治效果.结果 入选患者70例,男47例,女23例,年龄22～84岁,平均55.7岁.其中门诊患者25例,住院患者45例.穿刺肺门淋巴结120组,肺内肿块11例次.70例患者中,在没有采用现场细胞学诊断的条件下,46例初诊肺癌患者通过EBUS-TBNA明确诊断44例,假阴性2例,诊断肺癌的敏感度为96%,特异度为100%,阳性预测值为100%,阴性预测值为92%,准确率为97%;10例临床诊断为结节病的患者中,5例镜下可见上皮细胞形成的非干酪样肉芽肿改变;4例结核患者中,1例淋巴结涂片中找到抗酸杆菌,淋巴结活枪病理示凝固性坏死.所有患者手术期间未发生并发症.结论 EBUS-TBNA是诊断肺癌和其他不明因纵隔-肺门淋巴结肿大的一种安全、有效的方法.
目的 評價超聲支氣管鏡引導下的經支氣管針吸活檢(EBUS-TBNA)對縱隔和肺門淋巴結腫大和肺內腫塊的診斷價值和安全性.方法 對2009年7月至2010年1月上海市肺科醫院胸部CT檢查顯示胸腔內腫物和(或)縱隔-肺門淋巴結腫大的門診或住院患者行EBUS-TBNA,觀察診治效果.結果 入選患者70例,男47例,女23例,年齡22～84歲,平均55.7歲.其中門診患者25例,住院患者45例.穿刺肺門淋巴結120組,肺內腫塊11例次.70例患者中,在沒有採用現場細胞學診斷的條件下,46例初診肺癌患者通過EBUS-TBNA明確診斷44例,假陰性2例,診斷肺癌的敏感度為96%,特異度為100%,暘性預測值為100%,陰性預測值為92%,準確率為97%;10例臨床診斷為結節病的患者中,5例鏡下可見上皮細胞形成的非榦酪樣肉芽腫改變;4例結覈患者中,1例淋巴結塗片中找到抗痠桿菌,淋巴結活鎗病理示凝固性壞死.所有患者手術期間未髮生併髮癥.結論 EBUS-TBNA是診斷肺癌和其他不明因縱隔-肺門淋巴結腫大的一種安全、有效的方法.
목적 평개초성지기관경인도하적경지기관침흡활검(EBUS-TBNA)대종격화폐문림파결종대화폐내종괴적진단개치화안전성.방법 대2009년7월지2010년1월상해시폐과의원흉부CT검사현시흉강내종물화(혹)종격-폐문림파결종대적문진혹주원환자행EBUS-TBNA,관찰진치효과.결과 입선환자70례,남47례,녀23례,년령22～84세,평균55.7세.기중문진환자25례,주원환자45례.천자폐문림파결120조,폐내종괴11례차.70례환자중,재몰유채용현장세포학진단적조건하,46례초진폐암환자통과EBUS-TBNA명학진단44례,가음성2례,진단폐암적민감도위96%,특이도위100%,양성예측치위100%,음성예측치위92%,준학솔위97%;10례림상진단위결절병적환자중,5례경하가견상피세포형성적비간락양육아종개변;4례결핵환자중,1례림파결도편중조도항산간균,림파결활창병리시응고성배사.소유환자수술기간미발생병발증.결론 EBUS-TBNA시진단폐암화기타불명인종격-폐문림파결종대적일충안전、유효적방법.
Objective To evaluate the diagnostic yield and the safety of endobronchial ultrasoundguided transbronchial needle biopsy (EBUS-TBNA) in mediastinal and hilar lymph nodes and lung tumors. Methods EBUS-TBNA was performed in 70 patients with thoracic masses or mediastinal-hilar lymphoadenopathy proved by CT scan. Results From July 2009 to January 2010, 70 patients were included in the study. EBUS-guided TBNA was performed to obtain samples from mediastinal and hilar lymph nodes (120 stations) and lung tumors (11 masses). In 46 cases of newly diagnosed lung cancer, 44 were confirmed by EBUS-TBNA without on site cytology assistance, with 2 false negative cases. The sensitivity,specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA in the diagnosis of lung cancer were 96%, 100% , 100% , 92% and 97% respectively. Non-caseous granuloma formed by epithelioid cells was found in EBUS-TBNA histological specimen from 5 out of 10 patients with clinically diagnosed sarcoidosis. TBNA cytological smear showed acid-fast bacilli and histology of the lymph node demonstrated coagulatory necrosis from 1 out of 4 tuberculous cases. The procedure was uneventful, and there were no complications. Conclusion EBUS-TBNA is an effective and safe method for the diagnosis of bronchogenic carcinoma and unknown mediastinal-hilar lymphadenopathy.
