经支气管超声引导针吸活检术在纵隔病变诊断中的应用。
Application of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal lesions.
机构信息
Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100044, China.
出版信息
Chin Med J (Engl). 2011 Dec;124(23):3988-92.
BACKGROUND
Mediastinal lesions are often difficult to diagnose in clinical practice because of the unique anatomical position of the mediastinum, which makes performance of biopsy difficult. The value of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of lung cancer and mediastinal lymph node staging has been widely accepted. However, few studies have been conducted on the value of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis and differential diagnosis of mediastinal lesions. The current study was conducted to investigate the value of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis and differential diagnosis of isolated mediastinal lesions without lung abnormalities.
METHODS
We retrospectively analyzed the data of patients with isolated mediastinal lesions without lung abnormalities for whom endobronchial ultrasound-guided transbronchial needle aspiration examination was performed at the Department of Thoracic Surgery of Peking University People's Hospital, between September 2009 and December 2010. For patients who could not be diagnosed with endobronchial ultrasound-guided transbronchial needle aspiration, surgical biopsy or more than 6 months of clinical and imaging follow-up was carried out.
RESULTS
Endobronchial ultrasound-guided transbronchial needle aspiration was performed for 60 patients with isolated mediastinal lesions. Correct diagnosis was made in 48 cases. Nineteen cases were malignant, and 29 were benign. The rate of correct diagnosis was 80%. The sensitivity, specificity, and accuracy of endobronchial ultrasound-guided transbronchial needle aspiration in distinguishing benign from malignant mediastinal lesions were 95%, 100%, and 98%, respectively. The examination was tolerable for all patients. No associated complications were observed.
CONCLUSION
Endobronchial ultrasound-guided transbronchial needle aspiration is a safe and effective method of diagnosing mediastinal lesions.
背景
纵隔病变在临床实践中常常难以诊断，因为纵隔的解剖位置独特，使得进行活检困难。经支气管超声引导下经支气管针吸活检术（EBUS-TBNA）在肺癌诊断和纵隔淋巴结分期中的价值已被广泛接受。然而，关于 EBUS-TBNA 在纵隔病变的诊断和鉴别诊断中的价值的研究较少。本研究旨在探讨 EBUS-TBNA 在诊断和鉴别诊断无肺部异常的孤立性纵隔病变中的价值。
方法
我们回顾性分析了 2009 年 9 月至 2010 年 12 月在北京大学人民医院胸外科行 EBUS-TBNA 检查的无肺部异常的孤立性纵隔病变患者的资料。对于不能通过 EBUS-TBNA 诊断的患者，进行了外科活检或超过 6 个月的临床和影像学随访。
结果
对 60 例孤立性纵隔病变患者进行了 EBUS-TBNA 检查。48 例获得了正确诊断。19 例为恶性，29 例为良性。正确诊断率为 80%。EBUS-TBNA 鉴别良恶性纵隔病变的灵敏度、特异度和准确度分别为 95%、100%和 98%。所有患者均能耐受检查，无相关并发症发生。
结论
EBUS-TBNA 是一种安全有效的纵隔病变诊断方法。
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