经支气管针吸细胞学(TBNA)对粘膜下和支气管周围病变的诊断:支气管镜诊断肺癌的敏感性、优越性和补补性

Patil Shital, R. Patil, A. Rujuta
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Bronchoscopic lesions were categorized as submucosal lesions (SML) and peribronchial lesions (PBL). TBNA, FB, BB and BW were performed in all the cases during FOB. Results: Bronchoscopic abnormalities were documented as SML in 200 cases and PBL in 150 cases. In SML, diagnostic yield of TBNA & FB were 40.05% and 49.50% respectively. Additional diagnostic yield of other CDTs like BB and BW has nil effect on yield difference over forcep biopsy (P>0.11). In PBL, diagnostic yield of TBNA, FB & CDTs were 68.66%, 27.33% and 41.33% respectively. Additional CDTs like BB cytology and BW has additive yield to FB from 27.33% to 41.33% in PBL (P<0.00001). Sensitivity of TBNA in PBL is 96.19% while that of CDTs is 59 (P<0.00001). Conclusions: TBNA in submucosal lesions is complimentary to conventional diagnostic techniques in diagnosis of these lesions. TBNA in peribronchial lesions is most sensitive modality over conventional techniques and considered as ‘gold standard’ in these lesions. 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引用次数: 2

摘要

背景:肺癌是全球癌症死亡的主要原因。肺癌占印度所有癌症诊断的13.8%。材料与方法:2013年7月至2018年9月,在印度敏斯尔医学院支气管镜检查组和拉图尔Venkatesh胸科医院进行了一项前瞻性多中心观察性研究,旨在发现TBNA粘膜下和支气管周围病变在确认诊断中的作用,记录TBNA比其他技术(如支气管刷(BB)、支气管洗涤(BW)和钳活检(FB))的加性率,并观察任何与手术相关的不良事件,特别是TBNA在支气管周围病变中的不良事件。本研究根据临床及影像学表现纳入350例患者。支气管镜下病变分为粘膜下病变(SML)和支气管周围病变(PBL)。所有病例在FOB期间均行TBNA、FB、BB和BW检查。结果:支气管镜下异常为SML 200例,PBL 150例。SML中TBNA和FB的诊断率分别为40.05%和49.50%。其他CDTs如BB和BW的额外诊断率对产钳活检的诊断率差异无影响(P>0.11)。PBL中TBNA、FB和CDTs的诊断率分别为68.66%、27.33%和41.33%。额外的CDTs如BB细胞学和BW对PBL的FB的附加率从27.33%增加到41.33% (P<0.00001)。TBNA对PBL的敏感性为96.19%,CDTs的敏感性为59 (P<0.00001)。结论:TBNA对粘膜下病变的诊断是对常规诊断技术的补充。TBNA在支气管周围病变中比传统技术更敏感,被认为是这些病变的“金标准”。收稿日期:2019年5月12日;录用日期:2019年6月20日;发布日期:2019年6月24日欧洲呼吸医学杂志2019;1(1): 105 110。doi: 10.31488 / ejrm.102欧洲呼吸医学杂志*1,Rajesh patipati2, Ayachit Rujuta3。1 .印度拉图尔敏斯医科大学肺内科副教授;2 .印度拉图尔敏斯医科大学内科副教授。经支气管针吸细胞学(TBNA)在粘膜下和支气管周围病变中的应用:支气管镜诊断肺癌的敏感性、优越性和补充于传统诊断技术
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Transbronchial needle aspiration cytology (TBNA) in submucosal & peribronchial lesions: Sensitive, Superior & complimentary to Conventional diagnostic techniques during bronchoscopy in diagnosing lung cancer
Background: Lung Cancer is the leading cause of cancer deaths around the world. Lung cancer accounts for 13.8% of all cancer diagnosis in India. Materials and Methods: prospective multicentric observational study conducted during July 2013 to September 2018 at bronchoscopy unit of MIMSR Medical College, and Venkatesh Chest Hospital Latur India to find role of TBNA submucosal & peribronchial lesions in confirming the diagnosis, to document additive yield of TBNA over other techniques like Bronchial Brush (BB), Bronchial wash (BW) and Forcep Biopsy (FB), and to observe any procedure related adverse events especially TBNA in peribronchial lesions. The study included 350 patients on the basis of clinical and radiological features of malignancy. Bronchoscopic lesions were categorized as submucosal lesions (SML) and peribronchial lesions (PBL). TBNA, FB, BB and BW were performed in all the cases during FOB. Results: Bronchoscopic abnormalities were documented as SML in 200 cases and PBL in 150 cases. In SML, diagnostic yield of TBNA & FB were 40.05% and 49.50% respectively. Additional diagnostic yield of other CDTs like BB and BW has nil effect on yield difference over forcep biopsy (P>0.11). In PBL, diagnostic yield of TBNA, FB & CDTs were 68.66%, 27.33% and 41.33% respectively. Additional CDTs like BB cytology and BW has additive yield to FB from 27.33% to 41.33% in PBL (P<0.00001). Sensitivity of TBNA in PBL is 96.19% while that of CDTs is 59 (P<0.00001). Conclusions: TBNA in submucosal lesions is complimentary to conventional diagnostic techniques in diagnosis of these lesions. TBNA in peribronchial lesions is most sensitive modality over conventional techniques and considered as ‘gold standard’ in these lesions. Received: May 12, 2019; Accepted: June 20, 2019; Published: June 24, 2019 European Journal of Respiratory Medicine 2019; 1(1): 105 110. doi: 10.31488/ejrm.102 Eur J Respir Med,1:1 European Journal of Respiratory Medicine Patil Shital*1 , Rajesh Patil2 , Ayachit Rujuta3 1. Associate Professor, Pulmonary Medicine, MIMSR Medical College, Latur, India 2. Associate Professor, Internal Medicine, MIMSR Medical College, Latur, India 3. Professor, Histopathology & Oncopathology, MIMSR medical College, Latur, India Transbronchial needle aspiration cytology (TBNA) in submucosal & peribronchial lesions: Sensitive, Superior & complimentary to Conventional diagnostic techniques during bronchoscopy in diagnosing lung cancer
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