Sun Jia-Yuan, Han Bao-Hui, Zhao Heng, Zhang Jian, Feng Jiu-Xian, Zhang Jie, Sha Hui-Fang, Qi Da-Jiang, Gu Ai-Qin, Shen Jie, Feng Yun
Pulmonary Department, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2010 Oct;33(10):738-41.
To evaluate the diagnostic yield and the safety of endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNA) in mediastinal and hilar lymph nodes and lung tumors.
EBUS-TBNA was performed in 70 patients with thoracic masses or mediastinal-hilar lymphoadenopathy proved by CT scan.
From July 2009 to January 2010, 70 patients were included in the study. EBUS-guided TBNA was performed to obtain samples from mediastinal and hilar lymph nodes (120 stations) and lung tumors (11 masses). In 46 cases of newly diagnosed lung cancer, 44 were confirmed by EBUS-TBNA without on site cytology assistance, with 2 false negative cases. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA in the diagnosis of lung cancer were 96%, 100%, 100%, 92% and 97% respectively. Non-caseous granuloma formed by epithelioid cells was found in EBUS-TBNA histological specimen from 5 out of 10 patients with clinically diagnosed sarcoidosis. TBNA cytological smear showed acid-fast bacilli and histology of the lymph node demonstrated coagulatory necrosis from 1 out of 4 tuberculous cases. The procedure was uneventful, and there were no complications.
EBUS-TBNA is an effective and safe method for the diagnosis of bronchogenic carcinoma and unknown mediastinal-hilar lymphadenopathy.
评估支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）对纵隔及肺门淋巴结和肺部肿瘤的诊断价值及安全性。
对70例经CT扫描证实有胸部肿块或纵隔-肺门淋巴结肿大的患者进行EBUS-TBNA。
2009年7月至2010年1月，70例患者纳入研究。采用EBUS引导下TBNA从纵隔及肺门淋巴结（120个部位）和肺部肿瘤（11个肿块）获取样本。在46例新诊断的肺癌患者中，44例经EBUS-TBNA确诊，无需现场细胞学辅助，有2例假阴性病例。EBUS-TBNA诊断肺癌的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为96%、100%、100%、92%和97%。10例临床诊断为结节病的患者中，5例EBUS-TBNA组织学标本发现由上皮样细胞形成的非干酪样肉芽肿。4例结核病例中，1例TBNA细胞学涂片显示抗酸杆菌，淋巴结组织学显示凝固性坏死。操作过程顺利，无并发症发生。
EBUS-TBNA是诊断支气管源性肺癌和不明原因纵隔-肺门淋巴结肿大的一种有效且安全的方法。
