Division of Respiratory Critical Care and Occupational Pulmonary Medicine, University of Utah, Salt Lake City, Utah.
Division of Respiratory Critical Care and Occupational Pulmonary Medicine, University of Utah, Salt Lake City, Utah.
J Am Soc Cytopathol. 2020 Jul-Aug;9(4):249-253. doi: 10.1016/j.jasc.2020.04.009. Epub 2020 Apr 28.
Adequate sampling by endobronchial ultrasound (EBUS)-transbronchial needle aspiration to meet the demands of precision medicine or histologic evaluation is challenging. There is increasing demand for core biopsy specimens with advances in therapy. Franseen enodoscopic ultrasound needles have shown promising results in gastroenterology application for obtaining core biopsies and same design has recently been extended for pulmonary use. We evaluated Franseen needles with EBUS to assess its utility, safety and ability to provide core biopsy specimens.
Retrospective analysis of our database at the University of Utah of patients undergoing EBUS with a Franseen needle was performed to ascertain the performance characteristics of this needle in the first 100 patients after its implementation. Medical records were also reviewed to identify any immediate procedure-related complications.
One hundred seventy locations were sampled in 100 patients. A total of 152 lymph nodes and 18 masses were sampled. Core biopsies, as per pathology report, were seen in 87% of patients. A clinically concordant pathological diagnosis was established in 97% of patients. Diagnostic yield for granulomatous lymphadenopathy was 95.6% (22 of 23). No patient-related adverse events were noted.
The Franseen needle evaluated in this study can safely procure core tissue samples during EBUS bronchoscopy that are adequate for histopathological diagnosis in benign and malignant lesions. Its ability to provide adequate tissue in patients with granulomatous inflammation is encouraging.
经支气管内超声(EBUS)-经支气管针吸活检术(TBNA)进行充分取样以满足精准医学或组织学评估的需求具有挑战性。随着治疗方法的进步,对核心活检标本的需求也在增加。Fransen 内镜超声针在胃肠病学应用中获得核心活检方面取得了良好的效果,其相同设计最近也已扩展到肺部应用。我们使用 EBUS 评估了 Fransen 针,以评估其在 100 例患者中的应用效果、安全性和获取核心活检标本的能力。
对犹他大学数据库中接受 Fransen 针 EBUS 的 100 例患者进行回顾性分析,以确定该针在实施后的前 100 例患者中的性能特征。还回顾了病历以确定任何与操作相关的即时并发症。
在 100 例患者中,170 个部位进行了取样。共取样 152 个淋巴结和 18 个肿块。根据病理报告,87%的患者获得了核心活检标本。97%的患者建立了临床一致的病理诊断。肉芽肿性淋巴结病的诊断率为 95.6%(23 例中的 22 例)。未观察到与患者相关的不良事件。
本研究评估的 Fransen 针可在 EBUS 支气管镜检查期间安全地获取核心组织样本,这些样本足以对良恶性病变进行组织病理学诊断。其在肉芽肿性炎症患者中提供足够组织的能力令人鼓舞。