Xu Chuancai, Qin Lingyan, Lei Wei, Jiang Junhong, Ni Chongjun, Huang Jian'an
Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Pathology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Diagn Cytopathol. 2020 Apr;48(4):316-321. doi: 10.1002/dc.24374. Epub 2019 Dec 28.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, reliable technique for sampling mediastinal lymph nodes (LNs). Liquid-based cytology (LBC) is widely used for cervical cancer screening because it provides reliable and feasible results. The present study aimed to evaluate effectiveness of the combination of EBUS-TBNA and LBC in the diagnosis of mediastinal lymphadenopathy.
A total of 602 LNs that were retrospectively analyzed were sampled in 442 patients who underwent EBUS-TBNA between January 2014 and December 2016. The histopathological result of TBNA tissue or cell blocks was considered as the gold standard to evaluate diagnostic utility of LBC and conventional smears (CS) for the diagnosis of mediastinal lymphadenopathy.
Of the 602 LNs, 265 were mediastinal LN metastases from lung cancer, four were lymphoma, and 333 were benign. The sensitivity of LBC and CS in the diagnosis of mediastinal LN metastases from lung cancer was 72.8% and 63%, respectively, and the specificity was 98.5% and 97%, respectively. The positive predictive values for LBC and CS were 97.5% and 94.4%, respectively, whereas the negative predictive values were 82.2% and 76.9%, respectively. The accuracy of LBC and CS was 88% and 83.7%, respectively. The diagnostic value of LBC was significantly higher than that of CS (P = .001).
The combination of EBUS-TBNA and LBC is a highly reliable and feasible procedure that optimizes diagnostic utility for the diagnosis of lung cancer and mediastinal LN staging.
支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）是一种用于纵隔淋巴结（LN）采样的微创、可靠技术。液基细胞学检查（LBC）因其提供可靠且可行的结果而广泛用于宫颈癌筛查。本研究旨在评估EBUS-TBNA与LBC联合应用在纵隔淋巴结病诊断中的有效性。
回顾性分析了2014年1月至2016年12月期间接受EBUS-TBNA的442例患者的602个淋巴结。将TBNA组织或细胞块的组织病理学结果视为评估LBC和传统涂片（CS）对纵隔淋巴结病诊断的诊断效用的金标准。
在602个淋巴结中，265个是肺癌的纵隔淋巴结转移灶，4个是淋巴瘤，333个是良性的。LBC和CS对肺癌纵隔淋巴结转移的诊断敏感性分别为72.8%和63%，特异性分别为98.5%和97%。LBC和CS的阳性预测值分别为97.5%和94.4%，而阴性预测值分别为82.2%和76.9%。LBC和CS的准确率分别为88%和83.7%。LBC的诊断价值显著高于CS（P = 0.001）。
EBUS-TBNA与LBC联合应用是一种高度可靠且可行的方法，可优化肺癌诊断和纵隔淋巴结分期的诊断效用。
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