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超声支气管镜引导下经支气管针吸活检术(EBUS-TBNA)在高结核患病率人群中诊断良性疾病的效能。

Diagnostic efficacy of EBUS-TBNA in benign diseases in a population with a high prevalence of tuberculosis.

机构信息

Dr. Suat Seren Chest Diseases and Thoracic Surgery Education and Research Hospital, Izmir, Turkey.

Kemalpaşa State Hospital, İzmir, Turkey.

出版信息

Diagn Cytopathol. 2021 Mar;49(3):374-380. doi: 10.1002/dc.24661. Epub 2020 Nov 16.

Abstract

SETTING

Although endobronchial ultrasonography-transbronchial needle aspiration (EBUS-TBNA) has a well-known place in the staging and diagnosis of lung cancer, the place of EBUS is not clear in the diagnosis of benign diseases, especially in countries with a high prevalence of tuberculosis.

AIM

The aim of this study is to investigate the diagnostic efficacy of EBUS-TBNA in benign diseases in a population with a high prevalence of tuberculosis.

MATERIAL AND METHODS

Between October 2011 and March 2018, 1077 EBUS-TBNA was applied.

RESULTS

The diagnosis was reached with mediastinoscopy or video assisted thoracic surgery (VATS) in 41 (74.5%) and with the second EBUS-TBNA performed in 14 (25.5%) of 55 EBUS practices in 41 patients with malignancy diagnosis. The final diagnosis was achieved with clinical/radiological features in 7 (77.7%) cases of sarcoidosis, with VATS/mediastinoscopy in 2 (22.2%) cases, with EBUS-TBNA performed for the second time in 6 (54.5%) tuberculosis cases and with acid-resistance bacilli reproduction in Lowenstein-Jensen culture in 5 (45.4%) cases. Two hundred and ninety-five (79.7%) patients were accepted as "benign disease" due to the absence of radiological and clinical progression of lesions in the follow-up.

CONCLUSION

The diagnostic accuracy of EBUS-TBNA is high in benign diseases such as sarcoidosis and tuberculosis.

摘要

背景

虽然支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)在肺癌的分期和诊断中具有重要地位,但在良性疾病的诊断中,尤其是在结核病高发的国家,EBUS 的作用尚不明确。

目的

本研究旨在探讨在结核病高发人群中,EBUS-TBNA 对良性疾病的诊断效能。

材料和方法

2011 年 10 月至 2018 年 3 月期间,共进行了 1077 次 EBUS-TBNA。

结果

在 41 例恶性肿瘤诊断患者中,41 例(74.5%)通过纵隔镜或电视辅助胸腔镜手术(VATS),14 例(25.5%)通过对 55 例患者中的 41 例进行第二次 EBUS-TBNA 诊断出。在 7 例(77.7%)结节病患者中,通过临床/影像学特征明确诊断,2 例(22.2%)通过 VATS/纵隔镜检查明确诊断,6 例(54.5%)结核病患者通过第二次 EBUS-TBNA 明确诊断,5 例(45.4%)分枝杆菌耐酸杆菌在 Lowenstein-Jensen 培养中繁殖。295 例(79.7%)患者因随访中病变无影像学和临床进展而被接受为“良性疾病”。

结论

EBUS-TBNA 在诊断良性疾病如结节病和结核病方面具有较高的准确性。

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