Erer Onur Fevzi, Erol Serhat, Anar Ceyda, Aydoğdu Zekiye, Özkan Serir Aktoğu
Deparment of Chest Diseases, Izmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Izmir, Turkey.
Deparment of Pathology, Izmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Izmir, Turkey.
Endosc Ultrasound. 2017 Jul-Aug;6(4):265-268. doi: 10.4103/2303-9027.180763.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and minimally invasive procedure that can be performed in outpatient settings. Several studies have demonstrated the usefulness of EBUS-TBNA in the diagnosis of sarcoidosis and malignant diseases. This study focused on the role of cell block (CB) analysis in determining the diagnostic yield of EBUS-TBNA in malignant diseases and sarcoidosis.
The study was conducted at a training and research hospital. Records of patients who underwent EBUS-TBNA between March 2011 and December 2014 for diagnosed sarcoidosis or malignancy were retrospectively analyzed. Results of all EBUS-TBNA smears and CB were separately evaluated to determine the diagnostic value of each.
There were 84 sarcoidosis and 179 malignancy patients. In the malignancy group, CB contributed to cancer diagnosis in 15 (8.3%) patients and subclassification in 19 (10.6%) patients. In the sarcoidosis group, for 45.2% of patients (38/84), smears were not diagnostic but CB showed granulomatous inflammation.
CB significantly increases the diagnostic yield of EBUS-TBNA for sarcoidosis. In our study, in the malignancy group the diagnostic yield was low but it was helpful for subclassification, especially for adenocarcinoma.
支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)是一种安全且微创的操作,可在门诊进行。多项研究已证实EBUS-TBNA在结节病和恶性疾病诊断中的有用性。本研究聚焦于细胞块(CB)分析在确定EBUS-TBNA对恶性疾病和结节病的诊断阳性率方面的作用。
该研究在一家培训和研究医院开展。对2011年3月至2014年12月期间因确诊结节病或恶性肿瘤而接受EBUS-TBNA的患者记录进行回顾性分析。分别评估所有EBUS-TBNA涂片和细胞块的结果,以确定各自的诊断价值。
有84例结节病患者和179例恶性肿瘤患者。在恶性肿瘤组中,细胞块有助于15例(8.3%)患者的癌症诊断以及19例(10.6%)患者的亚型分类。在结节病组中,45.2%的患者(38/84)涂片未得出诊断结果,但细胞块显示有肉芽肿性炎症。
细胞块显著提高了EBUS-TBNA对结节病的诊断阳性率。在我们的研究中,恶性肿瘤组的诊断阳性率较低,但对亚型分类有帮助,尤其是对腺癌。