Aono Hiromi, Okamoto Hiroaki, Kunikane Hiroshi, Nagatomo Akira, Watanabe Koshiro, Nagai Atsushi
Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, and First Department of Medicine, Tokyo Women's Medical University, Japan.
Respirology. 2006 Nov;11(6):782-5. doi: 10.1111/j.1440-1843.2006.00928.x.
The aim of this study was to improve the staging of lung cancer with or without lymphadenopathy on chest CT by using transbronchial aspiration cytology (TBAC).
TBAC of the subcarinal lymph nodes was performed on 153 consecutive patients with lung cancer, with or without subcarinal lymphadenopathy on chest CT.
Thirty-four patients had enlargement of the subcarinal lymph nodes (>1 cm). Eighteen of these had TBAC confirmation of metastases. Another seven patients with no mediastinal involvement on CT were positive for metastases on TBAC. TBAC was the only way to confirm lung cancer in two patients. Therefore, routinely performed subcarinal TBAC contributed to an improved non-operative staging of the patients and diagnosis in 16% (25/153) of the patients with lung cancer. Forty-nine patients with NSCLC had surgical resection of the tumour. Surgical procedure revealed metastases to the subcarinal lymph nodes in three patients in whom the preoperative TBAC diagnosis was normal. No significant complications due to TBAC occurred in any of the patients.
TBAC of the subcarinal lymph nodes is a minimally invasive technique for staging of lung cancer and can provide useful information for the diagnosis of metastases to the subcarinal lymph nodes.
本研究的目的是通过经支气管针吸细胞学检查（TBAC）来改进胸部CT上有无淋巴结肿大的肺癌分期。
对153例连续的肺癌患者进行隆突下淋巴结的TBAC检查，这些患者在胸部CT上有无隆突下淋巴结肿大。
34例患者隆突下淋巴结肿大（>1 cm）。其中18例经TBAC证实有转移。另外7例CT显示无纵隔受累的患者经TBAC检查发现有转移。TBAC是2例患者确诊肺癌的唯一方法。因此，常规进行的隆突下TBAC有助于改善患者的非手术分期，并在16%（25/153）的肺癌患者中起到诊断作用。49例非小细胞肺癌患者接受了肿瘤手术切除。手术过程中发现，术前TBAC诊断正常的3例患者隆突下淋巴结有转移。所有患者均未因TBAC出现明显并发症。
隆突下淋巴结的TBAC是一种用于肺癌分期的微创技术，可为隆突下淋巴结转移的诊断提供有用信息。
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