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论文摘要

支气管内超声引导针吸活检术对肺门、纵隔淋巴结肿瘤和结核的诊断价值

The Diagnostic Value of Endobronchial Ultrasound-guided Needle Aspiration Biopsy for Lung or Mediastinal

作者:王业, 朱辉, 杨赛等

Author:WANG Ye, ZHU Hui, YANG Sai. et al

收稿日期:          年卷(期)页码:2017,48(3):347-351

期刊名称:四川大学学报(医学版)

Journal Name:JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION)

关键字:支气管内超声引导针吸活检术 肺门纵膈淋巴结 诊断

Key words:Endobronchial ultrasound-guided needle aspiration biopsy Lung or mediastinal lymph nodes Diagnosis

基金项目:

中文摘要

目的探讨支气管内超声引导针吸活检术(EBUS-TBNA)在肺门、纵膈淋巴结恶性肿瘤和结核诊断中的应用价值。方法回顾性分析2013年1月至2016年9月在四川大学华西医院呼吸内镜中心接受EBUS-TBNA检查的553例患者的临床及病理资料,统计EBUS-TBNA对肺门、纵膈淋巴结肿瘤和结核的诊断敏感性、特异性和准确率。结果EBUS-TBNA诊断肺门、纵膈淋巴结恶性肿瘤的敏感性、特异性和准确率分别为89.2%(263/295)、100.0%(247/247)和94.1%(510/542)。针吸活检组织查见肉芽肿诊断结核的敏感性、特异性和准确率分别为65.0%(76/117)、97.2%(385/396)和89.9%(461/513)。标本组织行抗酸染色和TB-PCR的102例中,查见抗酸杆菌或TB-PCR任一项阳性诊断结核的敏感性、特异性和诊断准确率为63.7%(58/91)、90.9%(10/11)和66.7%(68/102)。结论EBUS-TBNA诊断肺门和纵膈肿瘤具有较高的敏感性和特异性,并可联合抗酸染色和TB-PCR联合诊断肺门和纵膈淋巴结结核。

英文摘要

Objective To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in diagnosing lung or mediastinal lymph node cancer and tuberculosis. Methods Clinical and pathological data of 553 patients who underwent EBUS-TBNA from January 2013 to September 2016 in West China Hospital of Sichuan University were reviewed. The sensitivity, specificity and accuracy of EBUS-TBNA for diagnosing lymph node tumor and tuberculosis of hilar and mediastinal lymph nodes were calculated. Results The sensitivity, specificity and accuracy of EBUS-TBNA in diagnosing hilar and mediastinal lymph node cancer were 89.2% (263/295), 100% (247/247) and 94.1% (510/542), respectively, compared with 70% (76/117), 97.2% (385/396) and 89.9% (461/513), respectively, for diagnosing tuberculosis identified though granulomatous biopsy. In the 102 cases with acid fast staining and TB-PCR, 63.7% accuracy (58/91), 90.9% (10/11) sensitivity and 66.7% (68/102) specificity were found for any positive findings from acid fast bacilli or TB-DNA. Conclusion EBUS-TBNA has high sensitivity and specificity for diagnosing hilar and mediastinal tumor, which can be used in combination with acid fast staining and TB-PCR for diagnosing tuberculosis.

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