摘要
Abstract
Objective To compare the values of transbronchial needle aspiration ( TBNA) and endobronchial ultrasound - guided transbronchial needle aspiration(EBUS-TBNA)in the diagnosis of the nature of enlarged lymph nodes among patients with bronchial lung cancer. Methods 113 patients with bronchial lung cancer who underwent TBNA or EBUS-TBNA in the bronchoscope room in Affiliated Hospital of Hebei University during January 2012 to October 2014 were selected as study subjects. According to the way of biopsy,patients were divided into TBNA group(n = 66)and EBUS-TBNA group(n = 47). According to the site of puncture,patients in TBNA group and EBUS-TBNA group were also divided into central group(4R, 4L,7 according to ACCP intrathoracic lymph node partition)and peripheral group(11R,11L according to ACCP intrathoracic lymph node partition),respectively. According to 87 puncture sites in TBNA group,56 sites belonged to central group and 31 sites belonged to peripheral group;according to 63 puncture sites in EBUS-TBNA group,40 sites belonged to central group and 23 sites belonged to peripheral group. All specimen received cytological examination in pathology department,if cancer cells were found in cell smear,and classification was clear,specimens were judged to be puncture positive,if cancer cells were not found in cell smear,specimens were judged to be puncture negative. Golden criteria of diagnosis was pathological findings of sentinel node biopsy through surgery,thoracoscope or mediastinoscopy. Sensitivity,specificity and accuracy of different groups in the diagnosis of nature of enlarged lymph node was calculated respectively,and complications of patients were recorded. Results For the diagnosis of nature of enlarged lymph node,there was no significant difference in sensitivity,specificity and accuracy between central group of TBNA(80. 8% ,100. 0% and 82. 1% )and central group of EBUS-TBNA(91. 9% ,100. 0% and 92. 5% )respectively( P > 0. 05 ). Sensitivity and accuracy in peripheral group of TBNA ( 55. 2% and 58. 1% ) were significantly lower than those(85. 0% and 87. 0% )in peripheral group of EBUS-TBNA respectively(P < 0. 05). There was no significant difference in specificity between peripheral group of TBNA and peripheral group of EBUS-TBNA( 100. 0% vs. 100. 0% ,P > 0. 05). All patients can tolerate examination well. There was no significant difference in hemoptysis occurrence rate between TBNA group and EBUS-TBNA group(P > 0. 05). Conclusion Both EBUS-TBNA and TBNA can diagnose the nature of enlarged lymph nodes of 4R,4L,7 according to ACCP intrathoracic lymph node partition effectively. For the diagnosis of the nature of enlarged lymph nodes of 11R and 11L according to ACCP intrathoracic lymph node partition,the value of EBUS-TBNA is better than TBNA.关键词
肺肿瘤/淋巴结/活组织检查,针吸/支气管/超声波内窥镜Key words
Lung neoplasms/Lymph nodes/Biopsy,needle/Bronchi/Endosonography分类
医药卫生
