Zhang Lei, Cheng Gui-yu, Lü Ning, Mao You-sheng, Zhang Zhi-hui, Li Jian, Li Xiao-yan, Ni Xiao-guang, Lai Shao-qing, He Shun, Yu Gui-xiang, Ju Feng-huan, Xun Hua-ying, Cheng Rong-rong, Xu Pei-pei, Wang Gui-qi
Department of Endoscopy, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100021, China.
Zhonghua Yi Xue Za Zhi. 2010 Apr 27;90(16):1109-12.
To evaluate the diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in cases of undiagnosed intrapulmonary lesions.
A total of 89 patients with intrathoracic lesions underwent EBUS-TBNA, including 56 pulmonary lesions, 7 lymph node staging in lung cancer patients, 21 unknown hilar and/or mediastinal lymphadenopathies and 5 mediastinal tumors. All samples were evaluated for cytological and pathological examinations.
No complication of EBUS-TBNA was observed. Among 89 cases, 76 had positive results, 5 negative and 5 cases excluded as unsatisfied samples. In 56 patients with pulmonary lesions, EBUS-TBNA demonstrated 45 malignant tumors, 5 benign diseases, 3 suspicious cancers, 1 negative and 2 unsatisfied samples. In 7 lung cancer patients staged by EBUS-TBNA, 5 showed metastasis and 2 showed no metastasis. In 21 cases with mediastinal and/or hilar lymphadenopathy, EBUS-TBNA demonstrated 3 malignant tumors, 13 benign diseases, 2 negative and 3 unsatisfied samples. All 5 mediastinal lesions were malignant. Three suspicious cancers were confirmed, 1 by CT-guided percutaneous transthoracic needle biopsy and 2 by clinical follow-ups. In 2 lung cancer patients EBUS-TBNA showed negative, 1 surgical sample showed metastasis and another no metastasis by PET-CT. Three negative cases were diagnosed as benign by clinical follow-ups. The diagnostic sensitivity, specificity, positive predictive value and negative predictive value of EBUS-TBNA were 95%, 100%, 100% and 20% respectively.
EBUS-TBNA is both effective and safe in making a diagnosis of intrathoracic lesions.
评估支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）对未确诊的肺内病变的诊断价值。
89例胸内病变患者接受了EBUS-TBNA检查，其中包括56例肺部病变、7例肺癌患者的淋巴结分期、21例不明原因的肺门和/或纵隔淋巴结肿大以及5例纵隔肿瘤。所有样本均进行了细胞学和病理学检查。
未观察到EBUS-TBNA的并发症。89例中，76例结果为阳性，5例为阴性，5例因样本不满意被排除。在56例肺部病变患者中，EBUS-TBNA显示45例为恶性肿瘤，5例为良性疾病，3例为可疑癌症，1例为阴性，2例样本不满意。在7例经EBUS-TBNA分期的肺癌患者中，5例显示转移，2例未显示转移。在21例纵隔和/或肺门淋巴结肿大患者中，EBUS-TBNA显示3例为恶性肿瘤，13例为良性疾病，2例为阴性，3例样本不满意。所有5例纵隔病变均为恶性。3例可疑癌症得到确诊，1例通过CT引导下经皮经胸针吸活检确诊，2例通过临床随访确诊。2例肺癌患者EBUS-TBNA结果为阴性，1例手术样本显示转移，另1例PET-CT显示未转移。3例阴性病例经临床随访诊断为良性。EBUS-TBNA的诊断敏感性、特异性、阳性预测值和阴性预测值分别为95%、100%、100%和20%。
EBUS-TBNA对胸内病变的诊断既有效又安全。
