Li Shi-Yue, Chen Xiao-Bo, He Ying, Wang Jin-Lin, Chen Yu, Zhong Nan-Shan
Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical College, Key State Laboratory of Respiratory Diseases, Guangzhou 510120, China.
Zhonghua Yi Xue Za Zhi. 2009 Jun 23;89(24):1672-5.
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.
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.
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.
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.
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。
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。
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。
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。
