Department of Respiratory Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Respiratory Medicine, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong'an Road, Xicheng District, Beijing, China.
Ther Adv Respir Dis. 2020 Jan-Dec;14:1753466620907037. doi: 10.1177/1753466620907037.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely used, safe, and accurate technique for obtaining pathological specimens to be used in the diagnosis of diseases involving lung hilar and mediastinal lymph node (LN) enlargement. However, application of the suction technique during EBUS-TBNA remains controversial. In addition, the effectiveness of the slow-pull capillary technique for the diagnosis of pancreatic masses was recently reported. The aim of this study was to compare the diagnostic accuracy of EBUS-TBNA using these two techniques.
The accuracy, sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and availability of tissue cores of the suction and slow-pull capillary techniques were studied retrospectively in patients who underwent EBUS-TBNA for the diagnosis of diseases involving lung hilar and mediastinal LN enlargement.
A total of 97 patients with hilar and mediastinal LN enlargement underwent EBUS-TBNA; 30 patients underwent the suction technique, 56 patients underwent the slow-pull capillary technique, 5 patients underwent both techniques, and 6 patients had failed operations. The accuracy, sensitivity, specificity, NPV, PPV, and the number of tissue cores obtained with the suction and slow-pull capillary techniques were 66.67% 85.71% ( = 0.039), 43.75% 85.42% ( < 0.001), 92.86% 87.5% ( > 0.05), 59.09% 50% ( > 0.05), 87.5% 97.62% ( > 0.05), and 19 50 ( = 0.004), respectively. In both univariate and multivariate analyses, the acquisition of tissue core was significantly associated with the diagnostic accuracy of EBUS-TBNA. Moreover, the slow-pull capillary technique was significantly associated with the acquisition of tissue core in EBUS-TBNA. There were no significant differences between the two groups in the blood contamination of samples.
Use of the slow-pull capillary technique in EBUS-TBNA can significantly increase the accuracy related to the diagnosis of diseases involving hilar and mediastinal LN enlargement by improving the acquisition of tissue core.
经支气管超声引导针吸活检术（EBUS-TBNA）是一种广泛应用的、安全且准确的技术，可获取用于诊断肺门和纵隔淋巴结（LN）肿大相关疾病的病理标本。然而，在 EBUS-TBNA 中应用抽吸技术仍然存在争议。此外，最近有报道称缓慢牵拉毛细技术对胰腺肿块的诊断具有有效性。本研究旨在比较这两种技术在 EBUS-TBNA 中的诊断准确性。
回顾性研究了经 EBUS-TBNA 诊断肺门和纵隔 LN 肿大相关疾病的患者，比较了抽吸技术和缓慢牵拉毛细技术的诊断准确性、灵敏度、特异性、阴性预测值（NPV）、阳性预测值（PPV）和组织芯的可用性。
共有 97 例肺门和纵隔 LN 肿大的患者接受了 EBUS-TBNA 检查；30 例患者采用抽吸技术，56 例患者采用缓慢牵拉毛细技术，5 例患者同时采用了这两种技术，6 例患者操作失败。抽吸技术和缓慢牵拉毛细技术的诊断准确性、灵敏度、特异性、NPV、PPV 和获得的组织芯数量分别为 66.67%、85.71%（ = 0.039）、43.75%、85.42%（ < 0.001）、92.86%、87.5%（ > 0.05）、59.09%、50%（ > 0.05）、87.5%、97.62%（ > 0.05）和 19 比 50（ = 0.004）。单因素和多因素分析均表明，获取组织芯与 EBUS-TBNA 的诊断准确性显著相关。此外，在 EBUS-TBNA 中，缓慢牵拉毛细技术与获取组织芯显著相关。两组样本的血液污染无显著差异。
在 EBUS-TBNA 中使用缓慢牵拉毛细技术可通过提高组织芯的获取，显著提高与肺门和纵隔 LN 肿大相关疾病诊断准确性。
