Wang Ko-Pen, Symanowski James
*Chest Diagnostic Center, Harbor Hospital, Baltimore, MD †The Johns Hopkins University, Baltimore, MD ‡Interventional Pulmonology and Critical Care Medicine §Department of Biostatistics, Nevada Cancer Institute, Las Vegas, NV.
J Bronchology Interv Pulmonol. 2011 Jan;18(1):94-6. doi: 10.1097/LBR.0b013e3182087334.
Transbronchial needle aspiration (TBNA) is a 30 year old procedure for diagnosing and staging of lung cancer. There has been renewed interest in TBNA due to the development of a curvilinear array endobronchial ultrasound (EBUS) scope for TBNA. Reports indicate an increased diagnostic yield compared to standard TBNA. In 9 of 11 patients EBUS-TBNA is performed with the second generation Olympus EBUS scope (BF-UC180F) and the ViziShot (NA-201SX-4022) needle in addition to the standard WANG™ TBNA needle. Three punctures were made by the ViziShot needle. The first puncture, the guidewire is partially retracted and without suction the needle is moved back and forth inside the lesion. The second puncture, the guidewire is completely removed and suction is applied during needle movement. The third puncture is without the guidewire but with suction. In five patients with a positive diagnosis of cancer, the first punctures were all positive with a better quality and quantity of tumor cells. Three patients, standard TBNA needle was used, all were positive. Four patients with standard TBNA preceded the EBUS-TBNA were all positive. We conclude, EBUS TBNA is highly effective and dependable and suggest the use of EBUS needle can be simplified. Standard TBNA needle can be used for EBUS-TBNA and standard TBNA in relation to EBUS-TBNA needs to be further investigated.
经支气管针吸活检术（TBNA）是一项用于肺癌诊断和分期已有30年历史的技术。由于用于TBNA的曲线阵列支气管内超声（EBUS）内镜的发展，人们对TBNA重新产生了兴趣。报告显示，与标准TBNA相比，其诊断率有所提高。在11例患者中的9例中，除了标准的WANG™ TBNA针外，还使用第二代奥林巴斯EBUS内镜（BF-UC180F）和ViziShot（NA-201SX-4022）针进行EBUS-TBNA。ViziShot针进行了三次穿刺。第一次穿刺时，导丝部分缩回，不进行抽吸，针在病变内来回移动。第二次穿刺时，完全移除导丝，并在针移动过程中进行抽吸。第三次穿刺不使用导丝，但进行抽吸。在5例确诊为癌症的患者中，第一次穿刺均为阳性，肿瘤细胞的质量和数量更好。3例患者使用标准TBNA针，结果均为阳性。4例在EBUS-TBNA之前进行标准TBNA的患者结果也均为阳性。我们得出结论，EBUS TBNA高效且可靠，并建议可简化EBUS针的使用。标准TBNA针可用于EBUS-TBNA，与EBUS-TBNA相关的标准TBNA还需要进一步研究。
