[支气管超声引导下经支气管针吸(EBUS-TBNA)在肺癌诊断中的应用]。

Masaru Nishitsuji, Kenta Yamamura, Hiroki Matsuoka, Yuichi Tanbo, Yoshiki Demura, Koichi Nishi, Masaki Fujimura
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引用次数: 0

摘要

背景:尽管支气管镜检查在肺癌的诊断中起着重要的作用,但当经支气管入路失败时,需要更多的侵入性手术,如ct引导下的活检或手术。目的:探讨支气管超声-经支气管针吸(EBUS-TBNA)在肺癌诊断中的价值。研究对象和方法:我们回顾性评估了388例因胸部x线或CT显示异常阴影而接受支气管镜检查的122例最终诊断为肺癌的病例。当支气管镜入路可行时,进行常规经支气管肺活检或细胞学检查(常规入路)。每当纵隔或肺门淋巴结肿大至直径大于1cm,或有病变附于下呼吸道时,加入EBUS-TBNA。评估常规方法和EBUS-TBNA的诊断准确性。结果:122例经常规方法诊断为肺癌的79例,占64.8%。43例未确诊病例中,27例经EBUS-TBNA诊断为肺癌。其中106例(86.9%)经常规方法加EBUS-TBNA诊断为肺癌。所有患者均未见严重并发症。结论:EBUS-TBNA是一种安全有效的肺癌诊断及分期方法。
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[Endobronchial ultrasonic-guided transbronchial needle aspiration (EBUS-TBNA) for lung cancer diagnosis].

Background: Although bronchoscopy has an important role in the diagnosis of lung cancer, more invasive procedures, such as CT-guided biopsy or surgery, are needed when transbronchial approaches fail.

Objective: We investigated the usefulness of endobronchial ultrasonic-transbronchial needle aspiration (EBUS-TBNA) for lung cancer diagnosis.

Subjects and methods: We retrospectively evaluated 122 cases who were finally diagnosed to have lung cancer from among 388 cases who underwent bronchoscopy because of abnormal shadows on their chest X-ray or CT. When bronchoscopic approaches were possible, conventional transbronchial lung biopsy or cytology (conventional approaches) were done. EBUS-TBNA was added whenever mediastinal or hilar lymph nodes enlarged to more than 1 cm in diameter, or if there were lesions attached to the lower respiratory tract. The diagnostic accuracy of conventional approaches and EBUS-TBNA were assessed.

Results: The number of cases diagnosed as lung cancer by conventional approaches was 79 cases (64.8%) among the 122 cases examined. Of the 43 cases undiagnosed by these procedures, 27 cases were diagnosed as lung cancer by EBUS-TBNA. Thus, 106 cases (86.9%) were diagnosed as lung cancer using conventional approaches plus EBUS-TBNA. No severe complications were observed in all the subjects.

Conclusion: EBUS-TBNA is a safe and useful approach for the diagnosis of lung cancer together with staging.

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