Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Respiration. 2018;96(5):464-471. doi: 10.1159/000490192. Epub 2018 Jul 24.
Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is the preferred modality for sampling intrathoracic lymph nodes in patients with suspected sarcoidosis. Whether the number of revolutions of the needle inside the lymph node while performing TBNA affects the diagnostic yield is unknown.
The aim of this paper was to compare the yield of different numbers of needle revolutions (10 vs. 20) during EBUS-TBNA in sarcoidosis.
Consecutive subjects with a clinicoradiological suspicion of sarcoidosis were randomized 1: 1 to undergo EBUS-TBNA with either 10 (group 1) or 20 revolutions (group 2). The primary and secondary outcomes were the diagnostic yield and adequacy of aspirates, respectively. Other outcomes were procedure duration, gross blood contamination of the aspirates, and safety of the procedure.
Of the 171 subjects screened, 150 (mean age 43.5 years; 47.3% women) were randomized. A mean of 2.8 (group 1: 2.8, group 2: 2.7; p = 0.37) lymph nodes were sampled per subject with a mean of 2.1 passes per node in each group (p = 0.60). Among 133 subjects finally diagnosed with sarcoidosis, there was no difference (p = 0.65) in the diagnostic yield of EBUS-TBNA between group 1 (52/65, 80.0%) and group 2 (57/68, 83.8%). Adequate aspirates were obtained in 96.9 and 97.1% of the subjects in groups 1 and 2, respectively (p = 1.00). There was no difference in the procedure duration, the proportion of subjects with grossly bloody specimens, or complications between the 2 groups.
The diagnostic yield and specimen adequacy were not different when EBUS-TBNA was performed with 10 or 20 revolutions in subjects with sarcoidosis.
经支气管超声引导针吸活检术（EBUS-TBNA）是用于疑似结节病患者采样胸内淋巴结的首选方法。在进行 TBNA 时，针在淋巴结内旋转的圈数是否会影响诊断率尚不清楚。
本文旨在比较 EBUS-TBNA 中 10 圈（组 1）和 20 圈（组 2）两种不同旋转圈数对结节病诊断率的影响。
连续入组临床和影像学怀疑结节病的患者，1:1 随机分组接受 EBUS-TBNA，分别采用 10 圈（组 1）或 20 圈（组 2）。主要和次要结局分别为诊断率和抽吸物的充分性。其他结局包括操作时间、抽吸物的大体血污染程度和操作的安全性。
在筛查的 171 例患者中，150 例（平均年龄 43.5 岁；47.3%为女性）被随机分组。每组平均每例患者采样 2.8 个（组 1：2.8 个，组 2：2.7 个；p = 0.37）淋巴结，每组每个淋巴结平均穿刺 2.1 次（p = 0.60）。在最终诊断为结节病的 133 例患者中，组 1（65 例中的 52 例，80.0%）和组 2（68 例中的 57 例，83.8%）的 EBUS-TBNA 诊断率无差异（p = 0.65）。组 1 和组 2 分别有 96.9%和 97.1%的患者获得了足够的抽吸物（p = 1.00）。两组间操作时间、大体血标本比例或并发症均无差异。
在结节病患者中，EBUS-TBNA 行 10 圈或 20 圈旋转时，诊断率和标本充分性无差异。
