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经支气管针吸活检联合经食管超声内镜引导下细针穿刺活检对纵隔及肺门病变的诊断价值

[Diagnostic value of transbronchial needle aspiration combined with transesophageal endoscopic ultrasound-guided fine needle aspiration in mediastinal and pulmonary hilar lesions].

作者信息

Li Xiao-Yan, Cheng Gui-Yu, Zhang Zhi-Hui, Lü Ning, Zhang Yue-Ming, Zou Shuang-Mei, Xue Li-Yan, Zhang Lei, Ni Xiao-Guang, Lai Shao-Qing, He Shun, Yu Gui-Xiang, Ju Feng-Huan, Xun Hua-Ying, Cheng Rong-Rong, Wang Gui-Qi

机构信息

Department of Endoscopy, Cancer Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2009 Jul;31(7):536-40.

PMID:19950704
Abstract

OBJECTIVE

To evaluate the value of transbronchial needle aspiration (TBNA) combined with transesophageal endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of mediastinal and pulmonary hilar lesions as well as in the lymph node staging (N staging) of lung cancer.

METHODS

129 patients with mediastinal and pulmonary hilar lesions underwent either TBNA or EUS-FNA with cytological needle aspiration. The samples obtained from TBNA or EUS-FNA were examined by both cytologiy and histopathology.

RESULTS

Of the 129 patients, 59 underwent TBNA and 70 EUS-FNA. The diagnostic rate were 84.7% (50/59) by TBNA and 94.3% (66/70) by EUS-FNA, resepectively. The diagnosis of 116 (89.9%) patients were confirmed by either TBNA or EUS-FNA. The pathological and cytological diagnostic rates were 92.2% (107/116) and 88.0% (102/116), resepectively. The diagnostic rate was elevated by 8.4% (9/107) through pathological examination. The histological classification rates by cytological and pathological examination were 73.8% (76/116) and 89.3% (92/103), respectively. The diagnostic rate of histological classification was elevated by 35.5% (27/76) through pathological examination.

CONCLUSION

The combination of TBNA and EUS-FNA can improve the diagnostic rate for wider mediastinal and pulmlonary hilar lesions. Pathological examination of the samples obtained from the TBNA and EUS-FNA can elevate not only the rate of diagnosis but also the rate of histological classification.

摘要

目的

评估经支气管针吸活检术(TBNA)联合经食管超声内镜引导下细针穿刺活检术(EUS-FNA)在纵隔及肺门病变诊断以及肺癌淋巴结分期(N分期)中的价值。

方法

129例纵隔及肺门病变患者接受了TBNA或EUS-FNA细胞学针吸活检。对TBNA或EUS-FNA获取的样本进行细胞学和组织病理学检查。

结果

129例患者中,59例行TBNA,70例行EUS-FNA。TBNA诊断率为84.7%(50/59),EUS-FNA诊断率为94.3%(66/70)。116例(89.9%)患者通过TBNA或EUS-FNA确诊。病理和细胞学诊断率分别为92.2%(107/116)和88.0%(102/116)。通过病理检查诊断率提高了8.4%(9/107)。细胞学和病理检查的组织学分类率分别为73.8%(76/116)和89.3%(92/103)。通过病理检查组织学分类诊断率提高了35.5%(27/76)。

结论

TBNA与EUS-FNA联合应用可提高更广泛纵隔及肺门病变的诊断率。对TBNA和EUS-FNA获取的样本进行病理检查不仅可提高诊断率,还可提高组织学分类率。

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