Kambartel K, Krbek T, Voshaar T
Lungenzentrum Bethanien Moers, Abteilung für Pneumologie, Allergologie, Zentrum für Schlaf- und Beatmungsmedizin.
Pneumologie. 2012 Jul;66(7):426-31. doi: 10.1055/s-0032-1309400. Epub 2012 Apr 24.
Diagnostic findings of mediastinal metastasis are an important factor for the prognosis of and therapy for lung cancer. In this retrospective study we examined the role of endobronchial ultrasound with transbronchial needle aspiration (EBUS) and mediastinoscopy (MS) in patients with confirmed lung cancer. Between 01/2009 and 07/2011 we performed 111 EBUS procedures [partly in combination with transoesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA)] and 88 mediastinoscopies. The diagnostic accuracy of EBUS (94%) was superior to that of MS (86%) (p < 0.05). The negative predictive value of EBUS and MS was 83% for both, the sensitivity was 94% vs. 58%, the prevalence of N2 /N3 was 84% vs. 32% and the rate of complications was 0% vs. 3%. Due to the at least similar accuracy the EBUS should be the first diagnostic procedure for histological staging of the mediastinum in patients with lung cancer.
纵隔转移的诊断结果是影响肺癌预后和治疗的重要因素。在这项回顾性研究中，我们探讨了支气管内超声引导下经支气管针吸活检（EBUS）和纵隔镜检查（MS）在确诊肺癌患者中的作用。在2009年1月至2011年7月期间，我们进行了111例EBUS操作[部分与经食管内镜超声引导下细针穿刺活检（EUS-FNA）联合进行]以及88例纵隔镜检查。EBUS的诊断准确率（94%）高于MS（86%）（p<0.05）。EBUS和MS的阴性预测值均为83%，敏感性分别为94%和58%，N2/N3的发生率分别为84%和32%，并发症发生率分别为0%和3%。由于准确性至少相似，EBUS应作为肺癌患者纵隔组织学分期的首选诊断方法。
