[支气管镜检查在结节病诊断中的价值]

[The value of bronchoscopy in the diagnosis of sarcoidosis].

作者信息

Tong Bing, Xu Yan, Zhong Wei, Zhao Jing, Chen Minjiang, Shao Chi, Sun Xuefeng, Zhong Xu, Wang Mengzhao

机构信息

Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2015 Nov;38(11):839-43.

PMID:26850773

Abstract

OBJECTIVE

To evaluate the role of bronchoscopy in the diagnosis of sarcoidosis.

METHODS

A retrospective analysis was conducted for 200 patients who were diagnosed to have sarcoidosis and underwent bronchoscopy from June 2009 to June 2014 in Peking Union Medical College Hospital. The diagnostic value of different bronchoscopic procedures was analyzed.

RESULTS

Of the 200 patients, 145 were finally confirmed to have sarcoidosis by pathology through bronchoscopic sampling techniques. The diagnostic yields of endobronchial biopsy (EBB), transbronchial lung biopsy (TBLB), and EBUS-TBNA were 71.14%, 46.77%, 46.80%, respectively. The yields among the 3 techniques were statistically different. In those with mucosal lesions, the yield of EBB was 80.80%, while that of the combination of EBB, TBLB and EBUS-TBNA was 83.3%, the difference being not significant. In those without mucosal lesions, the yields of EBB, and the combination of EBB, TBLB and EBUS-TBNA were 20.8% and 48.0% respectively, with significant difference(χ(2)=4.463, P=0.035).

CONCLUSIONS

EBB is a preferred approach for the diagnosis of sarcoidosis with endobronchial abnormalities, while for cases without mucosal lesions, combined TBLB, EBUS-TBNA and bronchoalveolar lavage can improve the diagnostic yield.

摘要

目的

评估支气管镜检查在结节病诊断中的作用。

方法

对2009年6月至2014年6月在北京协和医院诊断为结节病并接受支气管镜检查的200例患者进行回顾性分析。分析不同支气管镜检查方法的诊断价值。

结果

200例患者中，145例最终通过支气管镜采样技术经病理确诊为结节病。支气管内活检（EBB）、经支气管肺活检（TBLB）和超声支气管镜引导针吸活检（EBUS-TBNA）的诊断阳性率分别为71.14%、46.77%、46.80%。这3种技术的阳性率有统计学差异。在有黏膜病变的患者中，EBB的阳性率为80.80%，而EBB、TBLB和EBUS-TBNA联合应用的阳性率为83.3%，差异无统计学意义。在无黏膜病变的患者中，EBB以及EBB、TBLB和EBUS-TBNA联合应用的阳性率分别为20.8%和48.0%，差异有统计学意义（χ(2)=4.463，P=0.035）。