[超声支气管镜引导下经支气管针吸活检术中C-ROSE在获取组织样本用于肺癌诊断中的价值]
[Value of C-ROSE During EBUS-TBNA to Obtain the Tissue Sample in the Diagnosis of Lung Cancer].
作者信息
Xiang Qing, Wan Tao, Hu Qianfang, Chen Hong, Li Dairong
机构信息
Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
出版信息
Zhongguo Fei Ai Za Zhi. 2018 Nov 20;21(11):833-840. doi: 10.3779/j.issn.1009-3419.2018.11.05.
BACKGROUND
Most of the patients with lung and (or) mediastinal occupying lesions are considered to be primary lung cancer clinically, and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a commonly useful operation to obtain the tissue sample and get definitive diagnosis of pathological tissues. In the EBUS-TBNA process, cytological rapid on-site evaluation (C-ROSE) is a useful technology. The purpose of our study is to discuss the value of C-ROSE in the diagnosis of lung cancer by EBUS-TBNA sampling.
METHODS
Retrospective analysis of 141 cases clinical data who were performed with EBUS-TBNA and suspected diagnosis primary lung cancer, which were found have mediastinal and (or) lung lesions (including the enlargement of the lymph nodes/mass) by computed tomography (CT). Among these patients, 81 patients were in the C-ROSE group and 60 patients were in the No C-ROSE group. The message of puncture and complication of EBUS-TBNA with or without C-ROSE were compared. At the same time, we analysis the sensitivity and specificity, positive predictive value, negative predictive value of C-ROSE combined with EBUS-TBNA in that of the diagnosis of lung cancer.
RESULTS
We found no statistical difference of the needle passes between C-ROSE group and No C-ROSE group. But in C-ROSE group, specimen qualified rate and diagnostic yields were signicantly higher than No C-ROSE group (98.77% vs 90.00%, 88.89% vs 75.00%, P<0.05), the incidence of complications in the C-ROSE group was signicantly lower than that in the No C-ROSE group (1.23% vs 11.67%, P<0.05). The sensitivity, specificity, positive predictive value and negative predictive value of C-ROSE combined with EBUS-TBNA in the diagnosis of lung cancer are 92.21%, 100.00%, 100.00% and 40.00%.
CONCLUSIONS
EBUS-TBNA combined with C-ROSE can improve the specimen qualified rate and diagnostic rate, also can reduce the complications thus worthy of further promotion.
背景
大多数肺部和（或）纵隔占位性病变患者临床上被考虑为原发性肺癌，而超声支气管镜引导下经支气管针吸活检术（EBUS-TBNA）是获取组织样本并明确病理组织诊断的常用操作。在EBUS-TBNA过程中，细胞学快速现场评估（C-ROSE）是一项有用的技术。本研究的目的是探讨C-ROSE在EBUS-TBNA采样诊断肺癌中的价值。
方法
回顾性分析141例行EBUS-TBNA且疑似诊断为原发性肺癌的患者临床资料，这些患者经计算机断层扫描（CT）发现有纵隔和（或）肺部病变（包括淋巴结肿大/肿块）。其中，81例患者为C-ROSE组，60例患者为非C-ROSE组。比较有无C-ROSE的EBUS-TBNA穿刺情况及并发症。同时，分析C-ROSE联合EBUS-TBNA在肺癌诊断中的敏感性、特异性、阳性预测值、阴性预测值。
结果
我们发现C-ROSE组与非C-ROSE组的穿刺针数无统计学差异。但C-ROSE组的标本合格率和诊断率显著高于非C-ROSE组（98.77%对90.00%，88.89%对75.00%，P<0.05），C-ROSE组的并发症发生率显著低于非C-ROSE组（1.23%对11.67%，P<0.05）。C-ROSE联合EBUS-TBNA在肺癌诊断中的敏感性、特异性、阳性预测值和阴性预测值分别为92.21%、100.00%、100.00%和40.00%。
结论
EBUS-TBNA联合C-ROSE可提高标本合格率和诊断率，还可减少并发症，因此值得进一步推广。
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