CAJ | 학술논문

目的探讨超声支气管镜引导下支气管针吸活检( EBUS-TBNA)在肺癌及纵隔病变中的诊断价值和安全性. 方法对本院的经胸部CT或PET-CT检查显示纵隔或肺门淋巴结肿大及胸内气管旁肿块(≥1 cm)的53例患者行EBUS-TBNA检查. 结果 53例患者中经病理学检查确诊恶性肿瘤43例,其中肺癌41例. 共穿刺68组淋巴结,肺内肿块11例,每组平均穿刺2. 1针. 41例肺癌患者中经EBUS-TBNA诊断39例,其中取得明确病理诊断37 例. 诊断肺癌灵敏度、特异度、准确率分别为95. 12%、100%、96. 23%,另经EBUS-TBNA明确1例转移性神经内分泌癌;4例临床诊断为结节病患者中,3例病理可见多个上皮样细胞增生性结节及非干酪样肉芽肿改变,3例诊断肺结核患者中2例病理可见类上皮样结节,伴郎罕氏巨细胞及坏死. 结论对于不明原因的纵隔淋巴结肿大、纵隔及近肺门处肿块的患者,EBUS-TBNA是一种安全、有效的诊断方法,有较高的诊断灵敏度、特异度,对肺癌手术治疗的准确分期提供帮助.
목적 탐토초성지기관경인도하지기관침흡활검( EBUS-TBNA)재폐암급종격병변중적진단개치화안전성. 방법 대본원적경흉부CT혹PET-CT검사현시종격혹폐문림파결종대급흉내기관방종괴(≥1 cm)적53례환자행EBUS-TBNA검사. 결과 53례환자중경병이학검사학진악성종류43례,기중폐암41례. 공천자68조림파결,폐내종괴11례,매조평균천자2. 1침. 41례폐암환자중경EBUS-TBNA진단39례,기중취득명학병리진단37 례. 진단폐암령민도、특이도、준학솔분별위95. 12%、100%、96. 23%,령경EBUS-TBNA명학1례전이성신경내분비암;4례림상진단위결절병환자중,3례병리가견다개상피양세포증생성결절급비간락양육아종개변,3례진단폐결핵환자중2례병리가견류상피양결절,반랑한씨거세포급배사. 결론 대우불명원인적종격림파결종대、종격급근폐문처종괴적환자,EBUS-TBNA시일충안전、유효적진단방법,유교고적진단령민도、특이도,대폐암수술치료적준학분기제공방조.
Objective To evaluate the diagnostic value and safety of endobronchial ultrasound-guided trans-bronchial needle aspiration ( EBUS-TBNA) for lung cancer and mediastinal lesions. Methods 36 patients that were suspected of lung cancer with mediastinal lymph node metastasis and 17 cases with unexplained mediastinal lymphad-enopathy were found by chest CT or PET-CT underwent the diagnosis by EBUS-TBNA from July 2013 to December 2014. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EBUS-TBNA were evaluated. Results In the 53 patients, 43 cases, including 41 lung cancers, were confirmed ma-lignant tumor by pathologically. EBUS-TBNA was successfully performed to obtain samples from 68 stations of lymph nodes (2. 1 puncture per station) and 11 lung lesions. During the 41 lung cancers, 39 cases were diagnosed by EBUS-TBNA, and 37 cases achieved clear pathological diagnosis through EBUS-TBNA. The diagnosis sensitivity, specificity and accuracy rate were 95. 12%, 100% and 96. 23%, respectively. 1 patient was diagnosed with metas-tastic neuroendocrine carcinoma. 4 cases were clinically diagnosed as sarcoidosis, and the plurality of epithelioid cell hyperplastic nodules and non caseous granuloma were observed in 3 of them under microscope. 3 patients were diag-nosed as pulmonary tuberculosis, and epithelioid nodules and groomsman Langerhans' giant cells and necrosis were observed in 2 of them. Conclusion EBUS-TBNA is an effective and safety tool with high sensitivity and specificity in the diagnosis of unexplained mediastinal lymph nodes, mediastinal and hilus mass.