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超声支气管镜引导下经支气管针吸活检术(EBUS-TBNA)及现场快速评价(ROSE)在肺癌诊断中的应用

The use of EBUS-TBNA and ROSE in the diagnosis of lung cancer.

作者信息

Şimon Mărioara, Pop Bogdan, Toma Iuliana Lăcrămioara, Vallasek Aletta Kinga, Şimon Ioan

机构信息

Department of Bronchology, "Leon Daniello" Clinic of Pulmonology, Cluj-Napoca, Romania;

出版信息

Rom J Morphol Embryol. 2017;58(1):79-87.

Abstract

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive method for diagnosing and staging of lung cancer. EBUS-TBNA obtained small specimens. Rapid on-site examination (ROSE) is a rapid, real-time examination method. The aim of our study is to evaluate the impact of ROSE on adequate specimen sampling, rapid results and high diagnostic rate. We present the experience of the Department of Bronchology, "Leon Daniello" Clinic of Pulmonology, Cluj-Napoca, Romania, with EBUS-TBNA as a tool for diagnostic of adenopathies of unknown etiology. We evaluated the diagnostic capacity of ROSE for malignant tumors, by considering the histopathological examination as the diagnostic "gold standard". In our retrospective and descriptive study, we analyze the data of 147 EBUS-TBNA examinations with ROSE and histopathological exam, performed for diagnostic purposes for hilar and mediastinal adenopathies of unknown origin. The age of the patients varied from 21 to 80 years, with an average age of 54.36 years. There were 98 male patients, representing 66.66% of the group. From the total of 90 cases of malignancy, 72 (80%) cases were identified as a primary lung tumor, 13 (14.44%) cases were identified as lymphoma, and five cases as malignant tumor of extrapulmonary origin. The sensitivity of the ROSE is 85.71%. By the introduction of this method, EBUS-TBNA with ROSE, in our country, we can diagnose patients with lung and mediastinal tumors, which cannot be diagnosed by traditional bronchoscopy. This brings a valuable contribution to the improvement of lung cancer diagnostic.

摘要

支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)是一种用于肺癌诊断和分期的微创方法。EBUS-TBNA获取的标本较小。快速现场评价(ROSE)是一种快速、实时的检查方法。我们研究的目的是评估ROSE对充足标本采样、快速出结果及高诊断率的影响。我们介绍了罗马尼亚克鲁日-纳波卡市“莱昂·达涅洛”肺病诊所支气管病科将EBUS-TBNA作为诊断不明病因腺病工具的经验。我们以组织病理学检查作为诊断“金标准”,评估了ROSE对恶性肿瘤的诊断能力。在我们的回顾性描述性研究中,我们分析了147例为诊断不明来源的肺门和纵隔腺病而进行的EBUS-TBNA检查及ROSE和组织病理学检查的数据。患者年龄从21岁到80岁不等,平均年龄为54.36岁。男性患者有98例,占该组的66.66%。在总共90例恶性肿瘤病例中,72例(80%)被确定为原发性肺癌,13例(14.44%)被确定为淋巴瘤,5例为肺外起源恶性肿瘤。ROSE的敏感性为85.71%。通过在我国引入这种方法,即带有ROSE的EBUS-TBNA,我们能够诊断出传统支气管镜无法诊断的肺和纵隔肿瘤患者。这为肺癌诊断的改善做出了宝贵贡献。

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