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[经支气管针吸活检术在诊断伴有纵隔和/或肺门淋巴结肿大的支气管源性癌中的应用]

[Transbronchial needle aspiration in the diagnosis of bronchogenic carcinoma with enlarged mediastinal and /or hilar lymph nodes].

作者信息

Wang Meng-Zhao, Chen Yong, Zhong Wei, Zhang Li, Xu Ling, Shi Ju-Hong, Zhong Xu, Xiao Yi, Cai Bai-Qiang, Li Long-Yun

机构信息

Department of Respiratory Diseases, Beijing Union Hospital, Chinese Academy Medical Sciences, Peking Union Medical College, Beijing 100730, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2006 Jul;28(7):533-5.

Abstract

OBJECTIVE

To evaluate the role of transbronchial needle aspiraion (TBNA) in the diagnosis of bronchogenic carcinoma with enlarged mediastinal and/or hilar lymph node.

METHODS

Patients with mediastinal and/or hilar lymphoadenopathy proven by CT scan were eligible for TBNA as reported by WANG. All specimen was directly and instantly smeared for cytological examination.

RESULTS

From June 2004 to May 2006, 77 such patients were examined: including 38 lung cancers, 35 lung benign diseases and 4 without definite diagnosis. All TBNA procedures were successfully carried out in 222/225 ( 98.7%). Positive TBNA rate was 81.6% (31/38) in patients who had been proven to suffer from bronchogenic carcinoma. The diagnosis of lung cancer was confirmed via TBNA only in 9 patients. A total of 63 lymph nodes in the 38 lung cancer patients were aspirated by TBNA with a positive rate of 65.1% (41/63). The sensitivity of TBNA was significantly correlated with pathology type, lymph node size and experience of the cytologist. Severe complications were rare except small amount of bleeding at the TBNA site (52/77, 67.5%).

CONCLUSION

TBNA is quite safe and helpful in diagnosis and staging of bronchogenic carcinoma, yet it is not helpful in diagnosis of benign lung diseases.

摘要

目的

评估经支气管针吸活检术(TBNA)在诊断伴有纵隔和/或肺门淋巴结肿大的支气管源性癌中的作用。

方法

如王所报道,经CT扫描证实有纵隔和/或肺门淋巴结病的患者符合TBNA检查条件。所有标本均直接即时涂片进行细胞学检查。

结果

2004年6月至2006年5月,对77例此类患者进行了检查:其中包括38例肺癌、35例肺部良性疾病和4例诊断不明确者。225次TBNA操作中有222次(98.7%)成功完成。经证实患有支气管源性癌的患者中,TBNA阳性率为81.6%(31/38)。仅通过TBNA确诊肺癌的患者有9例。38例肺癌患者共进行了63个淋巴结的TBNA针吸活检,阳性率为65.1%(41/63)。TBNA的敏感性与病理类型、淋巴结大小和细胞学家的经验显著相关。除TBNA部位少量出血外(52/77,67.5%),严重并发症罕见。

结论

TBNA在支气管源性癌的诊断和分期中相当安全且有帮助,但对肺部良性疾病的诊断无帮助。

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