Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
J Bras Pneumol. 2012 Jan-Feb;38(1):33-40. doi: 10.1590/s1806-37132012000100006.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of mediastinal lymph nodes. The objective of this study was to evaluate the preliminary results obtained with EBUS-TBNA in the diagnosis of lesions and mediastinal lymph node staging.
We evaluated patients with tumors or mediastinal adenopathy, diagnosed with or suspected of having lung cancer. The procedures were performed with the patients under sedation or under general anesthesia. Material was collected by EBUS-TBNA, after which it was prepared on slides, fixed in either absolute alcohol (for cytology) or formalin (for cell-block analysis).
We included 50 patients (30 males). The mean age was 58.3 ± 13.5 years. We performed 201 biopsies of 81 lymph nodes or mediastinal masses (mean of 2.5 punctures/biopsy). The quantity of material was considered sufficient for cytology in 37 patients (74%), 21 (57%) of whom were thus diagnosed with malignancy. Of the remaining 16 patients, 1 was diagnosed with tuberculosis, 6 entered clinical follow-up, and 9 underwent further investigation (2 diagnosed with neoplasm-false-negative results). The yield was higher when the procedure was performed for diagnostic purposes, as well as being higher in patients with lesions in multiple stations and in biopsies involving the subcarinal lymph node station. One patient had endobronchial bleeding, which was resolved with local measures. There were no deaths among the patients evaluated.
This preliminary experience shows that EBUS-TBNA is a safe procedure. Our diagnostic yield, although lower than that reported in the literature, was consistent with the learning curve for the method.
经支气管超声引导针吸活检术（EBUS-TBNA）是一种新的诊断和纵隔淋巴结分期方法。本研究旨在评估 EBUS-TBNA 在诊断病变和纵隔淋巴结分期中的初步结果。
我们评估了患有肿瘤或纵隔淋巴结病的患者，这些患者被诊断为或怀疑患有肺癌。在镇静或全身麻醉下进行这些程序。通过 EBUS-TBNA 采集材料，然后将其制备在载玻片上，用绝对酒精（用于细胞学）或福尔马林（用于细胞块分析）固定。
我们纳入了 50 名患者（30 名男性）。平均年龄为 58.3 ± 13.5 岁。我们对 81 个淋巴结或纵隔肿块进行了 201 次活检（平均每活检 2.5 次穿刺）。37 名患者（74%）的材料量足以进行细胞学检查，其中 21 名（57%）被诊断为恶性肿瘤。其余 16 名患者中，1 名被诊断为结核病，6 名进入临床随访，9 名接受了进一步检查（2 名被诊断为肿瘤-假阴性结果）。当该程序用于诊断目的时，其产量更高，在多个部位有病变的患者和涉及隆突下淋巴结站的活检中产量更高。1 名患者出现支气管内出血，经局部措施得到解决。在评估的患者中无死亡病例。
这项初步经验表明，EBUS-TBNA 是一种安全的程序。尽管我们的诊断率低于文献报道，但与该方法的学习曲线一致。
