Shure D, Fedullo P F
Chest. 1984 Nov;86(5):693-6. doi: 10.1378/chest.86.5.693.
Transcarinal needle aspiration for staging subcarinal nodes was performed in 134 consecutive patients with suspected bronchogenic carcinoma at the time of diagnostic fiberoptic bronchoscopy using a prototype 20-gauge by 1-cm needle. The aspiration was performed before examination of the lower airways to avoid cellular contamination. Twenty-four patients had benign primary disease and negative needle aspirates. The transcarinal needle aspirate was positive in 15 percent of the 110 patients with bronchogenic carcinoma. There were no false-positives, and the transcarinal needle aspirate was the only evidence of unresectability in 69 percent (11/16) of those in whom it was positive. In addition, two subgroups of patients were identified in whom the aspirate is most likely to be positive--patients with endobronchial tumors (24 percent; 15/63) and those with an abnormal carina at bronchoscopy (38 percent; 8/21). No complication occurred. We conclude that transcarinal needle aspiration is a low-risk procedure that can save a significant number of patients the morbidity and cost of surgical staging and that it should be performed at the time of diagnostic bronchoscopy in all patients with an endobronchial lesion or a visually abnormal carina.
在134例连续的疑似支气管源性癌患者行诊断性纤维支气管镜检查时，使用一种原型的20号1厘米长的穿刺针，对隆突下淋巴结进行经隆突针吸活检。在检查下气道之前进行针吸活检，以避免细胞污染。24例患者原发性疾病为良性且针吸活检结果为阴性。在110例支气管源性癌患者中，经隆突针吸活检结果为阳性的占15%。没有假阳性结果，在针吸活检结果为阳性的患者中，69%（11/16）的患者经隆突针吸活检是无法切除的唯一证据。此外，还确定了两个针吸活检最可能为阳性的患者亚组——支气管内肿瘤患者（24%；15/63）和支气管镜检查时隆突异常的患者（38%；8/21）。未发生并发症。我们得出结论，经隆突针吸活检是一种低风险的操作，可为大量患者避免手术分期的 morbidity 和费用，并且应在所有有支气管内病变或视觉上隆突异常的患者进行诊断性支气管镜检查时进行。 （注：原文中“morbidity”未明确准确含义，可能影响译文精准度）
