Department of Respiratory Medicine, Freeman Hospital, Newcastle upon Tyne, UK.
Respiration. 2013;86(3):229-36. doi: 10.1159/000350867. Epub 2013 Jul 17.
Endobronchial ultrasound-transbronchial nee dle aspiration (EBUS-TBNA) is a useful technique for cytological assessment of enlarged mediastinal lymph nodes with a high diagnostic yield for lung cancer. However, the small sample volume can be problematic in diagnosing benign diseases and for molecular analysis of malignant tumours.
The aim of the study was to evaluate a novel lymph node forceps for EBUS-guided lymph node biopsy (EBUS-transbronchial forceps biopsy; EBUS-TBFB) in malignant and benign conditions concerning safety, feasibility, and diagnostic yield.
Patients with enlarged mediastinal or hilar lymph nodes were included. EBUS-TBNA was performed followed by EBUS-guided TBFB with the lymph node forceps. Three biopsy specimens were obtained. The diagnostic yields of EBUS-TBFB, EBUS-TBNA, and the combination of both sampling techniques were compared. Complications were systematically recorded.
Fifty-five patients with enlarged mediastinal nodes were enrolled into this study. Specimens adequate for histological analysis were obtained in all but one case using EBUS-TBFB. EBUS-TBFB increased the diagnostic yield of EBUS-TBNA from 64 to 93% in benign conditions. The overall diagnostic yield was higher compared to EBUS-TBNA alone. EGFR mutation analysis could be achieved in the forceps biopsy samples as needed. No complications were observed.
EBUS-TBFB with a novel lymph node forceps is safe and provides adequate histological specimens of enlarged mediastinal lymph nodes. EBUS-TBFB increases the diagnostic yield in benign conditions and may add value in molecular analysis of non-small cell lung cancer.
经支气管超声引导针吸活检术（EBUS-TBNA）是一种用于评估纵隔淋巴结肿大的细胞学检查的有用技术，其对肺癌的诊断率较高。然而，小样本量在诊断良性疾病和恶性肿瘤的分子分析方面可能存在问题。
本研究旨在评估一种新型的用于 EBUS 引导下淋巴结活检的淋巴结活检钳（EBUS 经支气管活检钳活检；EBUS-TBFB）在良、恶性疾病中的安全性、可行性和诊断率。
纳入纵隔或肺门淋巴结肿大的患者。行 EBUS-TBNA 后，采用淋巴结活检钳行 EBUS 引导下 TBFB，获取 3 个活检标本。比较 EBUS-TBFB、EBUS-TBNA 及两者联合采样技术的诊断率。系统记录并发症。
本研究纳入了 55 例纵隔淋巴结肿大的患者。除 1 例外，所有患者均通过 EBUS-TBFB 获得了足够进行组织学分析的标本。EBUS-TBFB 将 EBUS-TBNA 在良性疾病中的诊断率从 64%提高到 93%。与单独使用 EBUS-TBNA 相比，总体诊断率更高。根据需要，可在钳取活检样本中进行 EGFR 突变分析。未观察到并发症。
采用新型淋巴结活检钳的 EBUS-TBFB 安全且可提供纵隔淋巴结肿大的充分组织学标本。EBUS-TBFB 提高了良性疾病的诊断率，并可能在非小细胞肺癌的分子分析中增加价值。
