Fruchter Oren, Breslavsky Anna, Brozgol Tatyana, Grossman Anna, Kessi Mikhailova, Bugayov Alexey, Shimelis Kassa, Vaknine Hananya, Sukmanov Oleg
Pulmonary Division, Wolfson Medical Center, Holon, Israel.
The Sackler School of Medicine, Tel Aviv University, The Internal Medicine Division, Tel Aviv, Israel.
Clin Respir J. 2018 May;12(5):1802-1808. doi: 10.1111/crj.12741. Epub 2017 Dec 4.
The quality of tissue acquisition during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a major determinant of the diagnostic yield of the procedure. In the tissue button (TB) technique, the retrieved cellular specimen is fixed in ethanol and subsequently scraped from slide using surgical blade into formaldehyde and processed like ordinary tissue biopsy thus potentially increasing its diagnostic value.
To retrospectively evaluate the diagnostic yield of a TB technique in patients undergoing EBUS-TBNA for various malignant and benign conditions.
The diagnostic yield of specimen obtained by two methods (TB and traditional cell-block technique) performed during the same procedure are outlined in 46 patients who underwent EBUS-TBNA (median age = 65, range 19-85 years).
Overall, in both malignant and benign conditions, TB resulted in clear diagnostic material in 43/46 (93.4%) patients. Specifically, TB provided clear histological diagnosis of malignancy (either primary lung cancer or metastases from extra-thoracic cancer) in 30/46 (65.2%) patients and granulomatous inflammation in 11/46 (23.9%) of patients. Only in two patients TB did not provide diagnostic material.
The newly introduced TB technique provides valuable histological diagnostic material during EBUS-TBNA both malignant and benign conditions. Given its simplicity and its high diagnostic yield, TB should be considered to be used as one of the preferred specimen acquisition modalities during EBUS-TBNA specimen processing. Direct comparison to alternative tissue processing techniques during EBUS-TBNA should be explored in further randomized prospective studies.
支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）期间获取组织的质量是该检查诊断率的主要决定因素。在组织纽扣（TB）技术中，获取的细胞标本用乙醇固定，随后用手术刀片从载玻片上刮下并放入甲醛中，像普通组织活检一样进行处理，从而有可能提高其诊断价值。
回顾性评估TB技术在接受EBUS-TBNA检查的各种恶性和良性疾病患者中的诊断率。
在46例接受EBUS-TBNA检查的患者（中位年龄=65岁，范围19-85岁）中，概述了在同一操作过程中通过两种方法（TB和传统细胞块技术）获取标本的诊断率。
总体而言，在恶性和良性疾病中，TB技术在43/46（93.4%）的患者中获得了清晰的诊断材料。具体而言，TB技术在30/46（65.2%）的患者中明确诊断为恶性肿瘤（原发性肺癌或胸外癌症转移），在11/46（23.9%）的患者中诊断为肉芽肿性炎症。只有2例患者TB技术未提供诊断材料。
新引入的TB技术在EBUS-TBNA检查中，无论是恶性还是良性疾病，都能提供有价值的组织学诊断材料。鉴于其操作简单且诊断率高，TB技术应被视为EBUS-TBNA标本处理过程中首选的标本采集方式之一。在进一步的随机前瞻性研究中，应探索与EBUS-TBNA检查中其他组织处理技术的直接比较。
