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[实时支气管内超声引导下经支气管针吸活检:肺癌纵隔及肺门淋巴结的初步研究]

[Real-time endobronchial ultrasound-guided transbronchial needle aspiration: preliminary study on mediastinal and hilar lymph nodes of lung cancer].

作者信息

Li Shi-Yue, Chen Xiao-Bo, He Ying, Wang Jin-Lin, Chen Yu, Zhong Nan-Shan

机构信息

Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical College, Key State Laboratory of Respiratory Diseases, Guangzhou 510120, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2009 Jun 23;89(24):1672-5.

Abstract

OBJECTIVE

To observe the value and safety of real-time endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) on mediastinal and hilar lymph nodes of lung cancer.

METHODS

During July 2008 to December 2008, 25 patients (18 males, 7 females), (68 +/- 9) years old, with proven or radiologically suspected lung cancer were enrolled. EBUS-TBNA was performed to obtain samples from 28 lymph nodes of these patients. And 28 lymph nodes of 26 same eligible patients [(18 males, 8 females, (66 +/- 8) years old] were sampled with conventional TBNA by the same operator during January 2008 to June 2008. A positive result was either a specific diagnosis (eg, malignant cells) or a lymphocyte-positive specimen. The results and complications of EBUS-TBNA versus conventional TBNA were compared.

RESULTS

The yield of EBUS-TBNA, 92.9%, was significantly higher than 60.7% (17/28 nodes) of conventional TBNA (chi2 = 8.114, P = 0.004). No pneumothorax, airway rupture, hemorrhage (> 5 ml) and other complications were observed for the patients operated with EBUS-TBNA and conventional TBNA.

CONCLUSIONS

Real-time EBUS guidance significantly increases the yield of TBNA on mediastinal and hilar lymph nodes of lung cancer, and EBUS-TBNA is safe. Further application studies are needed.

摘要

目的

观察实时支气管内超声(EBUS)引导下经支气管针吸活检术(TBNA)对肺癌纵隔及肺门淋巴结取材的价值及安全性。

方法

选取2008年7月至2008年12月期间25例(男18例,女7例),年龄(68±9)岁,经病理证实或影像学怀疑为肺癌的患者。采用EBUS-TBNA对这些患者的28个淋巴结进行取材。同时选取2008年1月至2008年6月期间26例符合条件的相同患者(男18例,女8例,年龄(66±8)岁)的28个淋巴结,由同一操作者采用传统TBNA进行取材。阳性结果为明确诊断(如恶性细胞)或淋巴细胞阳性标本。比较EBUS-TBNA与传统TBNA的取材结果及并发症。

结果

EBUS-TBNA的取材阳性率为92.9%,显著高于传统TBNA的60.7%(17/28个淋巴结)(χ2 = 8.114,P = 0.004)。接受EBUS-TBNA和传统TBNA操作的患者均未观察到气胸(5 ml)及其他并发症。

结论

实时EBUS引导显著提高了TBNA对肺癌纵隔及肺门淋巴结的取材阳性率,且EBUS-TBNA是安全的。尚需进一步的应用研究。

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