Khan Ajmal, Agarwal Ritesh, Aggarwal Ashutosh N, Gupta Nalini, Bal Amanjit, Singh Navneet, Gupta Dheeraj
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Natl Med J India. 2011 May-Jun;24(3):136-9.
Transbronchial needle aspiration (TBNA) is an established procedure for sampling the mediastinal lymph nodes. Data reported from India are limited on this routine procedure. We describe our experience of the efficacy, diagnostic accuracy and safety of TBNA.
We retrospectively reviewed all TBNAs done at our centre between 2006 and 2009. Under local anaesthesia, accessible lymph node stations were sampled thrice without fluoroscopy and without an on-site cytopathologist. Data are presented in a descriptive manner.
A total of 4513 diagnostic bronchoscopies were done, of which 473 (10.5%) underwent TBNA. There were 297 men (63%) and 176 women (37%) with a mean (SD) age of 46.2 (13.98) years. The most common clinical diagnoses were sarcoidosis (50.5%), lung cancer (26.8%), tuberculosis (8.7%) and others (14%). The overall efficacy of TBNA in sampling a mediastinal/hilar lymph node was 72%. The accuracy of TBNA in achieving a pathological diagnosis was 40.4%, whereas the diagnostic yield of a successful procedure was 56.8% (lymph nodes were successfully sampled in 193 of 340 procedures). The most common diagnoses on cytology were sarcoidosis and lung cancer. In patients with a clinical diagnosis of lung cancer, the diagnostic accuracy of TBNA was 46.5% (59 of 127), whereas in patients with sarcoidosis it was 38.1% (91 of 239). TBNA provided an additional diagnostic yield in 5.6% (12 of 215) of patients with sarcoidosis who also underwent transbronchial lung biopsy. There were no periprocedural complications.
Blind TBNA is a safe and effective procedure that can be routinely done in the bronchoscopy suite.
经支气管针吸活检术（TBNA）是一种用于纵隔淋巴结采样的既定程序。印度报道的关于该常规程序的数据有限。我们描述了我们在TBNA的有效性、诊断准确性和安全性方面的经验。
我们回顾性分析了2006年至2009年在我们中心进行的所有TBNA。在局部麻醉下，对可触及的淋巴结站进行了三次采样，无需透视且无需现场细胞病理学家。数据以描述性方式呈现。
共进行了4513例诊断性支气管镜检查，其中473例（10.5%）接受了TBNA。有297名男性（63%）和176名女性（37%），平均（标准差）年龄为46.2（13.98）岁。最常见的临床诊断为结节病（50.5%）、肺癌（26.8%）、结核病（8.7%）和其他（14%）。TBNA对纵隔/肺门淋巴结采样的总体有效性为72%。TBNA实现病理诊断的准确性为40.4%，而成功操作的诊断率为56.8%（340例操作中有193例成功采集到淋巴结）。细胞学上最常见的诊断为结节病和肺癌。在临床诊断为肺癌的患者中，TBNA的诊断准确性为46.5%（127例中的59例），而在结节病患者中为38.1%（239例中的91例）。TBNA在5.6%（215例中的12例）同时接受经支气管肺活检的结节病患者中提供了额外的诊断率。没有围手术期并发症。
盲法TBNA是一种安全有效的程序，可在支气管镜检查室常规进行。
