Liu Aiqun, Qian Liwen, Zhong Yi, Lu Xiaoling, Zhao Yongxiang
National Center for International Research of Biological Targeting Diagnosis and Therapy, Guangxi Key Laboratory of Biological Targeting Diagnosis and Therapy Research, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Medical University, Nanning, Guangxi, 530021, China.
Affiliated Tumor Hospital, Guangxi Medical University, Nanning, Guangxi, 530021, China.
Ann Med Surg (Lond). 2017 Jul 25;23:1-7. doi: 10.1016/j.amsu.2017.07.055. eCollection 2017 Nov.
The purpose of this study was to evaluate the utility of EBUS-TNA for mediastinal mass or suspected lung cancer patients with mediastinal or hilar lymph node enlarged. Further to investigate the clinical value of EBUS-TBNA combining with immunohistochemistry and genotype in lung cancer.
A total of 55 patients with mediastinal, and/or hilar lymphadenopathy, and/or mediastinal mass previously detected by CT or PET/CT scan and who underwent EBUS-TBNA. An additional immunohistological analysis was performed for establishing a reliable diagnosis and sub classification when necessary. Some samples were tested for the EGFR and/or ALK mutations to provide suitable mutational genotyping for adenocarcinoma by using the PCR assays.
Of the 55 patients, the sensitivity and diagnostic accuracy of EBUS-TBNA in the diagnosis of lung cancer were 92.5% (37/40) and 94.5% (52/55), respectively. 37 samples were further confirmed and obtained particular type by Immunohistochemistry. 6 cases of EBUS-TBNA samples from patients with lung adenocarcinoma referred for EGFR testing were analyzed, 4 patients were found to have EGFR gene mutations. The procedure was uneventful without any complications.
EBUS-TBNA is a safe and efficient method with high sensitivity and specificity in the diagnosis of lung cancer. Uniquely combining with Immunohistochemistry and molecular testing has significant clinical value in subtype diagnosis and guiding the treatment strategy in lung cancer.
本研究旨在评估超声内镜引导下经支气管针吸活检术（EBUS-TNA）对纵隔肿块或纵隔或肺门淋巴结肿大的疑似肺癌患者的应用价值。进一步探讨EBUS-TBNA联合免疫组织化学和基因分型在肺癌中的临床价值。
共有55例纵隔和/或肺门淋巴结肿大和/或纵隔肿块患者，此前经CT或PET/CT扫描检测到，并接受了EBUS-TBNA检查。必要时进行额外的免疫组织学分析以建立可靠的诊断和亚分类。使用聚合酶链反应（PCR）检测对一些样本进行表皮生长因子受体（EGFR）和/或间变性淋巴瘤激酶（ALK）突变检测，为腺癌提供合适的突变基因分型。
55例患者中，EBUS-TBNA诊断肺癌的敏感性和诊断准确性分别为92.5%（37/40）和94.5%（52/55）。37个样本通过免疫组织化学进一步确诊并获得特定类型。对6例接受EGFR检测的肺腺癌患者的EBUS-TBNA样本进行分析，发现4例患者存在EGFR基因突变。该操作顺利，无任何并发症。
EBUS-TBNA是一种安全有效的方法，在肺癌诊断中具有高敏感性和特异性。与免疫组织化学和分子检测独特结合在肺癌亚型诊断和指导治疗策略方面具有重要临床价值。
