Gasparini Stefano, Zuccatosta Lina, Sediari Michele, Mei Federico
Pulmonary Diseases Unit, Department of Internal Medicine, Immunoallergic and Respiratory Diseases, Azienda Ospedaliero-Universitaria "Ospedali Riuniti," Ancona, Italy.
J Bronchology Interv Pulmonol. 2009 Jul;16(3):183-7. doi: 10.1097/LBR.0b013e3181afde66.
Cutting transbronchial histology needles to obtain tissue cores from hilar/mediastinal lymph nodes or masses adjacent to the tracheobronchial tree are able to provide adequate histology tissue samples in only 38% to 78% of cases. The aim of this pilot study was to evaluate the efficacy and safety of a new instrument developed to obtain a fragment of a tissue for histologic diagnosis of enlarged subcarinal lymph nodes.
The transbronchial needle forceps (TBNF) is a sampling instrument that combines the characteristics of a needle (beveled tip for penetrating through the bronchial wall) with that of a forceps (2 serrated jaws for grasping the biopsy). The external diameter of the needle forceps is 1.5 mm.
Fourteen patients (11 male, 3 female; mean age: 51 y) with subcarinal lymph node enlargement greater than 2 cm in short axis were included in this pilot study. TBNF provided tissue for histologic diagnosis in 8 patients (57.1%). In 4 patients (28.5%) TBNF could not be inserted through the bronchial wall. For patients in whom it was possible to insert the TBNF, a tissue core adequate for histologic examination was obtained in 9 (90%) and a diagnosis in 8 (80%) (non-small-cell lung cancer in 3, sarcoidosis in 2, small cell lung cancer in 1, tuberculosis in 1, and Hodgkin lymphoma in 1). No clinically significant procedure-related complications were encountered.
This study demonstrates that, when insertion through the bronchial wall is possible, TBNF safely provides diagnostic histologic specimens of subcarinal lymphadenopathy in a large percentage of cases.
使用经支气管组织学穿刺针从肺门/纵隔淋巴结或气管支气管树附近的肿块获取组织芯，在仅38%至78%的病例中能够提供足够的组织学组织样本。这项初步研究的目的是评估一种新开发的用于获取组织碎片以对隆突下肿大淋巴结进行组织学诊断的器械的有效性和安全性。
经支气管活检钳（TBNF）是一种采样器械，它结合了针（斜面尖端用于穿透支气管壁）和钳（2个锯齿状钳口用于抓取活检组织）的特性。活检钳的外径为1.5毫米。
本初步研究纳入了14例短轴大于2厘米的隆突下淋巴结肿大患者（11例男性，3例女性；平均年龄：51岁）。TBNF为8例患者（57.1%）提供了用于组织学诊断的组织。在4例患者（28.5%）中，TBNF无法穿过支气管壁插入。对于能够插入TBNF的患者，9例（90%）获得了足够用于组织学检查的组织芯，8例（80%）做出了诊断（3例为非小细胞肺癌，2例为结节病，1例为小细胞肺癌，1例为结核病，1例为霍奇金淋巴瘤）。未遇到临床上显著的与操作相关的并发症。
本研究表明，当能够穿过支气管壁插入时，TBNF在很大比例的病例中能够安全地提供隆突下淋巴结病变的诊断性组织学标本。
