Zhang Liang, Mao Feng, Cai Minghui, Shen-Tu Yang
Shanghai Chest Hospital, Shanghai Jiaotong University, Department of Thoracic Cancer, Shanghai Lung Tumor Clinical Medical Center, Shanghai 200030, China.
Zhongguo Fei Ai Za Zhi. 2013 Jun;16(6):289-93. doi: 10.3779/j.issn.1009-3419.2013.06.03.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been gradually universal application, but its value in the preoperative staging of lung cancer and mediastinal mass biopsy remains to be explored. The aim of this study is to evaluate the value of clinical application between mediastinoscopy and EBUS-TBNA, desiring to provide an objective basis for the rational choice applications.
Between July 2009 and December 2012, mediastinoscopy patients with 361 cases accepted biopsy, including 199 cases of lung cancer and 162 cases of mediastinal mass of unknown origin, EBUS-TBNA patients with 348 cases accepted biopsy, including 216 cases of lung cancer and 132 cases of mediastinal mass. Comparing the diagnostic results and related indicators of two methods, this article analyzed the clinical value both the preoperative staging of lung cancer and the diagnosis of mediastinal mass.
Taking pathology diagnosis as the gold standard, the accuracy, sensitivity and specificity of mediastinoscopy and EBUS-TBNA are 98.33%, 98.17%, 100% and 90.80%, 90.00%, 100%. Two techniques in the diagnosis and staging of lung cancer have not statistically significant (P>0.05), but in the diagnosis of mediastinal mass have statistical significance (P<0.05).
Mediastinoscopy and EBUS-TBNA have a similar role in the diagnosis and staging of lung cancer; but mediastinoscopy for mediastinal mass is superior to EBUS-TBNA.
支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)已逐渐广泛应用,但其在肺癌术前分期及纵隔肿物活检中的价值仍有待探讨。本研究旨在评估纵隔镜检查与EBUS-TBNA的临床应用价值,以期为合理选择应用提供客观依据。
2009年7月至2012年12月,361例接受纵隔镜检查的患者接受活检,其中肺癌199例,不明来源纵隔肿物162例;348例接受EBUS-TBNA的患者接受活检,其中肺癌216例,纵隔肿物132例。比较两种方法的诊断结果及相关指标,分析二者在肺癌术前分期及纵隔肿物诊断中的临床价值。
以病理诊断为金标准,纵隔镜检查与EBUS-TBNA的准确率、敏感度及特异度分别为98.33%、98.17%、100%及90.80%、90.00%、100%。两种技术在肺癌诊断及分期方面无统计学差异(P>0.05),但在纵隔肿物诊断方面有统计学差异(P<0.05)。
纵隔镜检查与EBUS-TBNA在肺癌诊断及分期中作用相似;但纵隔镜检查在纵隔肿物诊断方面优于EBUS-TBNA。