Groth Shawn S, Andrade Rafael S
Division of Thoracic and Foregut Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
Semin Thorac Cardiovasc Surg. 2008 Winter;20(4):274-8. doi: 10.1053/j.semtcvs.2008.11.004.
Mediastinoscopy is the gold standard for mediastinal lymph node (MLN) staging for non-small cell lung cancer patients; however, mediastinoscopy is invasive and allows access to a limited number of American Thoracic Society MLN stations (1, 2, 3, 4, and 7). Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is emerging as a useful, less invasive staging technique that offers access to a wider range of MLN stations (2, 3, 4, 7, 10, and 11). Although EBUS-TBNA has excellent sensitivity and diagnostic accuracy, an alternative MLN biopsy technique (i.e., mediastinoscopy or thoracoscopy) is required to confirm negative cytology findings, especially after induction therapy. Additionally, an experienced cytopathologist is critical to establishing an effective EBUS-TBNA program.
纵隔镜检查是对非小细胞肺癌患者进行纵隔淋巴结（MLN）分期的金标准；然而，纵隔镜检查具有侵入性，且只能检查有限数量的美国胸科学会MLN分站（1、2、3、4和7区）。支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）正逐渐成为一种有用的、侵入性较小的分期技术，它能够检查范围更广的MLN分站（2、3、4、7、10和11区）。尽管EBUS-TBNA具有出色的敏感性和诊断准确性，但对于阴性细胞学检查结果，尤其是在诱导治疗后，仍需要采用另一种MLN活检技术（即纵隔镜检查或胸腔镜检查）来进行确认。此外，一名经验丰富的细胞病理学家对于建立有效的EBUS-TBNA方案至关重要。
