Bhatti Hammad A, Bajwa Abubakar, Bhatti Junaid A, Cury James, Shujaat Adil, Jones Lisa, Usman Faisal
Division of Pulmonary and Critical Care Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USA.
J Bronchology Interv Pulmonol. 2013 Apr;20(2):107-12. doi: 10.1097/LBR.0b013e3182903d86.
The purpose of this study was to evaluate the diagnostic yield of endobronchial ultrasound with real-time-guided transbronchial needle aspiration (EBUS-TBNA), endobronchial forceps biopsy (EBBx), and 2D fluoroscopic-guided transbronchial forceps biopsy (TBLBx) for centrally located peribronchial lung lesions.
A retrospective chart review of consecutive patients who underwent EBUS-TBNA of centrally located peribronchial lesions, that is, medial margin of the mass within inner third of hemithorax by computerized tomography scan. Patients who underwent EBUS-TBNA for lymph node sampling were excluded.
Thirty-two cases met the inclusion criteria. The mean age was 69±12 years. Sixteen (50%) were male patients. Of the 32 EBUS-TBNA cases, 13 underwent concomitant TBLBx (group 1), 8 had concomitant EBBx (group 2), and 11 had EBUS-TBNA alone (group 3). In group 1, the diagnostic yield of EBUS-TBNA was 95% (n=12/13), whereas the yield of TBLBx was 61% (n=8/13). In group 2, the diagnostic yield of EBUS-TBNA was 100% (n=8/8), whereas EBBx was positive in 75% (n=6/8). In group 3, the diagnostic yield of EBUS-TBNA was 91% (n=10/11). Overall diagnostic yield of EBUS-TBNA of centrally located peribronchial lung lesions was 94% (n=30/32).
Where available, EBUS-TBNA of centrally located peribronchial lung lesions should be given a strong consideration given its high diagnostic yield.
本研究旨在评估支气管内超声引导下实时经支气管针吸活检（EBUS-TBNA）、支气管内钳夹活检（EBBx）以及二维透视引导下经支气管钳夹活检（TBLBx）对中央型支气管周围肺病变的诊断价值。
对连续接受中央型支气管周围病变EBUS-TBNA的患者进行回顾性病历分析，即通过计算机断层扫描，病变肿块的内侧边缘位于半侧胸腔内三分之一处。排除接受EBUS-TBNA进行淋巴结采样的患者。
32例符合纳入标准。平均年龄为69±12岁。16例（50%）为男性患者。在32例EBUS-TBNA病例中，13例同时接受了TBLBx（第1组），8例同时接受了EBBx（第2组），11例仅接受了EBUS-TBNA（第3组）。在第1组中，EBUS-TBNA的诊断阳性率为95%（n=12/13），而TBLBx的阳性率为61%（n=8/13）。在第2组中，EBUS-TBNA的诊断阳性率为100%（n=8/8），而EBBx的阳性率为75%（n=6/8）。在第3组中，EBUS-TBNA的诊断阳性率为91%（n=10/11）。中央型支气管周围肺病变EBUS-TBNA的总体诊断阳性率为94%（n=30/32）。
在可行的情况下，鉴于其高诊断阳性率，应优先考虑对中央型支气管周围肺病变进行EBUS-TBNA。
