Xiong Shenghua, Liu Nian, Han Qingbing, Jiang Yong, Su Xueying
Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China.
E-mail:
Zhonghua Bing Li Xue Za Zhi. 2015 Sep;44(9):633-8.
To explore the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) combined with Surepath liquid-based cytology test for lung and mediastinal lymphadenopathy.
Eighty EBUS-TBNA cases in West China Hospital of Sichuan University collected from December 2011 to June 2014 were retrospectively analyzed. The conventional smears and Surepath liquid based preparations were reviewed and compared with histological biopsy. Evaluated whether liquid based preparation could improve the satisfactory rate and diagnostic accuracy.
This study included 53 men and 27 women, the male to female ratio was 1.96:1.00; the age ranged from 17 to 79 (mean 54) years. One to four lymph node groups were aspirated in each patient, resulting in a total of 109 lymph node groups, including 57 paratracheal, 34 subcarinal, three tracheal bronchial, seven pulmonary and four hilar lymph node groups. The definite locations of four other mediastinal lymph node groups were not known. The overall satisfactory rate of conventional smears and liquid-based cytology test was 90.0% and 92.5%, respectively. By histology, there were 37 cases diagnosed as malignant tumors, nine as tuberculosis, two as sarcoidosis, 11 as unexplained granulomatous inflammation, and 27 as other benign lesions. The sensitivity, specificity and accuracy of conventional cytological smears for tumors were 86.5%, 97.7% and 92.5% respectively; the positive and negative predictive values were 97.0% and 89.4% respectively. The sensitivity, specificity and accuracy of the liquid-based preparation were 89.2%, 97.7% and 93.8% respectively; the positive and negative predictive values were 97.1% and 91.3% respectively. Combining the conventional cytological smears and liquid based preparation, the sensitivity, specificity and accuracy were 91.9%, 97.7% and 95.0% respectively; and the positive and negative predictive values were 97.1% and 93.3% respectively.
EBUS-TBNA is a good method to diagnose lung and mediastinal lymphadenopathy. Surepath liquid based cytology test could improve the sample satisfactory rate, the diagnostic sensitivity and accuracy. If combined with immunocytochemistry it could be useful for further tumor typing. EBUS-TBNA combined with Surepath liquid based preparation is an effective complement for the histologic biopsy.
探讨支气管内超声引导针吸活检术（EBUS-TBNA）联合Surepath液基细胞学检测对肺及纵隔淋巴结病变的诊断价值。
回顾性分析2011年12月至2014年6月四川大学华西医院收治的80例行EBUS-TBNA检查的患者资料。对传统涂片和Surepath液基制片进行阅片，并与组织学活检结果进行比较。评估液基制片能否提高标本满意率及诊断准确性。
本研究共纳入患者80例，其中男性53例，女性27例，男女比例为1.96∶1.00；年龄17～79岁，平均（54）岁。每位患者穿刺1～4组淋巴结，共穿刺109组淋巴结，其中气管旁淋巴结57组，隆突下淋巴结34组，气管支气管淋巴结3组，肺门淋巴结7组，肺内淋巴结4组。另外4组纵隔淋巴结位置不明确。传统涂片和液基细胞学检测的总标本满意率分别为90.0%和92.5%。组织学诊断结果显示，恶性肿瘤37例，结核9例，结节病2例，不明原因肉芽肿性炎症11例，其他良性病变27例。传统细胞学涂片对肿瘤诊断的敏感度、特异度和准确度分别为86.5%、97.7%和92.5%；阳性预测值和阴性预测值分别为97.0%和89.4%。液基制片诊断肿瘤的敏感度、特异度和准确度分别为89.2%、97.7%和93.8%；阳性预测值和阴性预测值分别为97.1%和91.3%。联合传统细胞学涂片和液基制片，诊断肿瘤的敏感度、特异度和准确度分别为91.9%、97.7%和95.0%；阳性预测值和阴性预测值分别为97.1%和93.3%。
EBUS-TBNA是诊断肺及纵隔淋巴结病变的良好方法。Surepath液基细胞学检测可提高标本满意率、诊断敏感度和准确度。联合免疫细胞化学有助于进一步肿瘤分型。EBUS-TBNA联合Surepath液基制片是组织学活检的有效补充。
