Hazeki Nobuko, Tachihara Motoko, Tsukamoto Ryuko, Tokunaga Shuntaro, Tamura Daisuke, Shinke Haruko, Kobayashi Kazuyuki, Sakai Yasuhiro, Nishimura Yoshihiro
Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; Kobe University Hospital Respiratory Center, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Diagnostic Pathology Department of Pathology, Kobe University Hospital, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Respir Investig. 2017 Mar;55(2):161-165. doi: 10.1016/j.resinv.2016.10.004. Epub 2016 Nov 28.
The demand for adequate tissue samples for both morphological assessment and molecular studies on lung cancer treatment has increased. The aim of this study was to evaluate whether cell blocks (CBs) prepared from endobronchial ultrasonography with guide sheath (EBUS-GS) rinsing following catheter aspiration provide additional information.
We produced CBs from rinse fluid obtained from washing the inside of the sheath with saline after conventional EBUS-GS between May 2012 and April 2013. During the first 7 months, the sheath was aspirated with 20mL of negative pressure while moving the catheter back and forth [aspiration group (Asp)]. During the next 5 months, the sheath was not aspirated, but only rinsed out [conventional group (Con)]. Patients diagnosed with lung cancer by EBUS-GS and/or CBs were identified and evaluated. The diagnostic rate of each sampling method was compared between the two groups. The number of tumor cells was also compared between the CB and EBUS-guided transbronchial lung biopsy (EBUS-TBB) groups.
EBUS-GS was performed on 113 patients. Fifty-five patients were included in this study (Asp=30, Con=25). The diagnostic yield of CBs in Asp was higher than that in Con (56.7% vs 32.0%; p=0.06). Asp showed no significant difference in the number of tumor cells between CB and EBUS-TBB. One patient who showed negative EBUS-TBB pathological results but positive CB results was diagnosed only by immunohistological staining of CB.
CB prepared from EBUS-GS rinsing following catheter aspiration may provide additional information.
肺癌治疗中，对用于形态学评估和分子研究的充足组织样本的需求不断增加。本研究的目的是评估经导管抽吸后，用导鞘支气管内超声检查（EBUS-GS）冲洗制备的细胞块（CBs）是否能提供更多信息。
我们从2012年5月至2013年4月期间常规EBUS-GS后用生理盐水冲洗鞘管内部获得的冲洗液中制备细胞块。在最初的7个月里，在来回移动导管的同时，用20mL负压抽吸鞘管[抽吸组（Asp）]。在接下来的5个月里，不抽吸鞘管，仅进行冲洗[常规组（Con）]。确定并评估通过EBUS-GS和/或CBs诊断为肺癌的患者。比较两组中每种采样方法的诊断率。还比较了CB组和EBUS引导下经支气管肺活检（EBUS-TBB）组的肿瘤细胞数量。
对113例患者进行了EBUS-GS检查。本研究纳入了55例患者（Asp = 30例，Con = 25例）。Asp组中CBs的诊断率高于Con组（56.7%对32.0%；p = 0.06）。Asp组CB与EBUS-TBB之间的肿瘤细胞数量无显著差异。1例EBUS-TBB病理结果为阴性但CB结果为阳性的患者仅通过CB的免疫组织化学染色确诊。
经导管抽吸后用EBUS-GS冲洗制备的CB可能提供更多信息。
