Schenk D A, Bower J H, Bryan C L, Currie R B, Spence T H, Duncan C A, Myers D L, Sullivan W T
Am Rev Respir Dis. 1986 Jul;134(1):146-8. doi: 10.1164/arrd.1986.134.1.146.
Transbronchial needle aspiration (TBNA) has been advocated as a reliable technique in the nonsurgical staging of patients with bronchogenic carcinoma. Some have questioned the reliability of TBNA, however. We used TBNA directed by computed tomography (CT) in 88 consecutive patients with bronchogenic carcinoma who had undergone chest CT. Chest CT was 94% sensitive, 79% specific, and 85% accurate in evaluating the mediastinum for malignant lymphadenopathy. There were 19 malignant aspirates in 44 patients with malignancy and apparent adenopathy evaluated by chest CT. No malignant carinal aspirates were obtained in any patient with a normal mediastinum evaluated by chest CT. There were 2 false positive needle aspirates. One patient with apparent right paratracheal adenopathy and malignant needle aspirate had no mediastinal neoplasm detected at surgery. The other false positive aspirate had been contaminated by tracheal debris. The overall sensitivity, specificity, and accuracy of TBNA mediastinal staging were 50, 96, and 78%, respectively. We conclude that CT scanning is a useful adjunct in the staging of patients with bronchogenic carcinoma, and that TBNA is a sensitive and highly specific staging technique that may negate the need for surgical staging in a large number of patients with bronchogenic carcinoma.
经支气管针吸活检术（TBNA）已被视为对支气管源性癌患者进行非手术分期的可靠技术。然而，有些人对TBNA的可靠性提出了质疑。我们对88例连续接受胸部CT检查的支气管源性癌患者采用了计算机断层扫描（CT）引导下的TBNA。在评估纵隔恶性淋巴结病方面，胸部CT的敏感性为94%，特异性为79%，准确性为85%。在44例经胸部CT评估为恶性且有明显淋巴结病的患者中，有19例吸出物为恶性。在经胸部CT评估纵隔正常的任何患者中，均未获得恶性隆突吸出物。有2例假阳性针吸活检。1例右气管旁淋巴结病明显且针吸活检为恶性的患者，手术时未发现纵隔肿瘤。另一例假阳性吸出物被气管碎片污染。TBNA纵隔分期的总体敏感性、特异性和准确性分别为50%、96%和78%。我们得出结论，CT扫描是支气管源性癌患者分期的有用辅助手段，TBNA是一种敏感且高度特异的分期技术，可能使大量支气管源性癌患者无需进行手术分期。
