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支气管内超声引导下经支气管针吸活检术用于非小细胞肺癌的淋巴结分期

Endobronchial ultrasound-guided transbronchial needle aspiration for nodal staging in non-small cell lung carcinoma.

作者信息

Coutinho D, Oliveira A, Campainha S, Neves S, Guerra M, Miranda J, Furtado A, Tente D, Sanches A, Almeida J, Moura E Sá J

机构信息

Respiratory Endoscopy Unit, Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal.

Respiratory Endoscopy Unit, Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal.

出版信息

Rev Port Pneumol (2006). 2017 Mar-Apr;23(2):85-89. doi: 10.1016/j.rppnen.2016.12.006. Epub 2017 Feb 9.


DOI:10.1016/j.rppnen.2016.12.006
PMID:28196610
Abstract

INTRODUCTION: Lung cancer staging has recently evolved to include endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for nodal assessment. AIM: Evaluate the performance and safety of EBUS-TBNA as a key component of a staging algorithm for non-small cell lung carcinoma (NSCLC) and as a single investigation technique for diagnosis and staging of NSCLC. METHODS: Patients undergoing EBUS-TBNA for NSCLC staging at our institution between April 1, 2010 and December 31, 2014 were consecutively included with prospective data collection. EBUS-TBNA was performed under general anesthesia through a rigid scope. RESULTS: A total of 122 patients, 84.4% males, mean age 64.2 years. Histological type: 78 (63.9%) adenocarcinoma, 33 (27.0%) squamous cell carcinoma, 11 (8.9%) undifferentiated/other NSCLC. A total of 435 lymph node stations were punctured. Median number of nodes per patient was 4. EBUS-TBNA nodal staging: 63 (51.6%) N0; 8 (6.5%) N1; 34 (27.9%) N2, and 17 (13.9%) N3. EBUS-TBNA was the primary diagnostic procedure in 27 (22.1%) patients. EBUS-TBNA NSCLC staging had a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rate of 83.3, 100, 100, 86.1, and 91.8%, respectively. No complications were attributable to the procedure. CONCLUSION: A comprehensive lung cancer staging strategy that includes EBUS-TBNA seems to be safe and effective. Our EBUS-TBNA performance and safety in this particular setting was in line with previously published reports. Additionally, our study showed that, in selected patients, lung cancer diagnosis and staging are achievable with a single endoscopic technique.

摘要

引言:肺癌分期最近已发展到包括用于淋巴结评估的支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)。 目的:评估EBUS-TBNA作为非小细胞肺癌(NSCLC)分期算法的关键组成部分以及作为NSCLC诊断和分期的单一检查技术的性能和安全性。 方法:2010年4月1日至2014年12月31日期间在我院接受EBUS-TBNA进行NSCLC分期的患者被连续纳入并进行前瞻性数据收集。EBUS-TBNA在全身麻醉下通过硬镜进行。 结果:共122例患者,男性占84.4%,平均年龄64.2岁。组织学类型:腺癌78例(63.9%),鳞状细胞癌33例(27.0%),未分化/其他NSCLC 11例(8.9%)。共穿刺435个淋巴结站。每位患者的淋巴结中位数为4个。EBUS-TBNA淋巴结分期:N0为63例(51.6%);N1为8例(6.5%);N2为34例(27.9%),N3为17例(13.9%)。EBUS-TBNA是27例(22.1%)患者的主要诊断方法。EBUS-TBNA对NSCLC分期的敏感性、特异性、阳性预测值、阴性预测值和诊断准确率分别为83.3%、100%、100%、86.1%和91.8%。该操作未引起任何并发症。 结论:包括EBUS-TBNA的综合肺癌分期策略似乎是安全有效的。我们在这一特定情况下的EBUS-TBNA性能和安全性与先前发表的报告一致。此外,我们的研究表明,在选定的患者中,通过单一内镜技术即可实现肺癌的诊断和分期。

相似文献

[1]
Endobronchial ultrasound-guided transbronchial needle aspiration for nodal staging in non-small cell lung carcinoma.

Rev Port Pneumol (2006). 2017

[2]
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J Thorac Cardiovasc Surg. 2014-10

[3]
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[4]
Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS).

Endoscopy. 2015-6

[5]
Is it necessary to sample the contralateral nodal stations by EBUS-TBNA in patients with lung cancer and clinical N0 / N1 on PET-CT?

Lung Cancer. 2020-4

[6]
Endobronchial ultrasound-guided transbronchial needle aspiration for differentiating N0 versus N1 lung cancer.

Ann Thorac Surg. 2013-8-15

[7]
Diagnostic performance of endobronchial ultrasound-guided mediastinal lymph node sampling in early stage non-small cell lung cancer: A prospective study.

Respirology. 2017-8-30

[8]
[Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer diagnosis and staging in 179 patients].

Rev Port Pneumol. 2013

[9]
Endobronchial ultrasound-guided transbronchial needle aspiration for lymph node staging in patients with non-small cell lung cancer in non-operable patients pursuing radiotherapy as a primary treatment.

J Thorac Oncol. 2010-5

[10]
A prospective controlled trial of endobronchial ultrasound-guided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph node staging of lung cancer.

J Thorac Cardiovasc Surg. 2011-10-2

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