Mehta A C, Kavuru M S, Meeker D P, Gephardt G N, Nunez C
Department of Pulmonary Disease, Cleveland Clinic Foundation.
Chest. 1989 Dec;96(6):1228-32. doi: 10.1378/chest.96.6.1228.
Fine-gauge (22-G) transbronchial needle aspiration (TBNA) has significantly added to the diagnostic yield of FOB, and in some institutions has become routine in staging bronchogenic carcinoma. Cytologic examination of the specimen obtained by n228G TBNA, however, has several limitations. The mediastinal aspirate can be contaminated by tumor cells from respiratory secretions, giving false positive diagnoses of unresectability. The diagnosis of benign conditions can seldom be made. Using 18-G TBNA, we can obtain specimens for histologic examination from paratracheal, peribronchial, and carinal areas by FOB. Both 18-G and 22-G TBNA were performed in 34 patients with radiographic abnormalities involving mediastinal or hilar areas. Tissue for histologic examination was obtained in 17 patients (50 percent) using 18-G TBNA and was diagnostic in 11 (32 percent), including three patients with benign conditions. The overall diagnostic yeild of 18-G TBNA was 41 percent (14/34 patients), increasing the yield of FOB from 50 percent to 58 percent. There were no false positive results and few minor complications. 18-G TBNA is effective in obtaining tissue for histologic examination and diagnosing benign conditions. In selected cases this technique increases the diagnostic yield of FOB.
细针（22G）经支气管针吸活检（TBNA）显著提高了纤维支气管镜检查（FOB）的诊断率，在一些机构已成为支气管源性癌分期的常规检查。然而，通过22G TBNA获取的标本进行细胞学检查存在一些局限性。纵隔吸出物可能被呼吸道分泌物中的肿瘤细胞污染，导致对不可切除性的假阳性诊断。很少能做出良性疾病的诊断。使用18G TBNA，我们可以通过FOB从气管旁、支气管周围和隆突区域获取用于组织学检查的标本。对34例影像学检查显示纵隔或肺门区域有异常的患者进行了18G和22G TBNA检查。使用18G TBNA，17例患者（50%）获取了用于组织学检查的组织，其中11例（32%）诊断明确，包括3例良性疾病患者。18G TBNA的总体诊断率为41%（14/34例患者），将FOB的诊断率从50%提高到58%。没有假阳性结果，轻微并发症也很少。18G TBNA在获取用于组织学检查的组织和诊断良性疾病方面是有效的。在某些病例中，该技术提高了FOB的诊断率。
