背景:纵隔和肺门病变可能是良性或恶性的。支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)由于微创且安全,因此越来越多地用于这些病变的诊断。
目的:探讨EBUS-TBNA在纵隔及肺门病变诊断及鉴别诊断中的临床疗效。
方法:采用回顾性观察性研究,对我院2020-2021年根据影像学诊断为纵隔和肺门淋巴结病的患者进行调查。经过评估,使用EBUSTBNA,数据包括穿刺部位,术后病理,并记录并发症。
结果:来自137名患者的数据被纳入研究,其中135例成功进行了EBUSTBNA。共进行149次淋巴结穿刺,其中90次穿刺确定了恶性病变。最常见的恶性肿瘤是小细胞肺癌,腺癌,和鳞状细胞癌。确认了41个良性病变,结节病引起的,结核病,和反应性淋巴结炎,在其他人中。随访结果显示4例为恶性肿瘤,合并肺结核1例,结节病1例)。随后通过其他方法确认了淋巴结穿刺不足的四个样本。EBUSTBNA对恶性病变的敏感性,纵隔和肺门病变的结核和结节病占94.7%,71.4%,和93.3%,分别。同样,阴性预测值(NPV)为88.9%,98.5%,99.2%,准确率为96.3%,98.5%,99.3%。
结论:EBUSTBNA是诊断纵隔和肺门病变的一种有效可行的方法,具有微创和安全性。
BACKGROUND: Mediastinal and hilar lesions may be benign or malignant. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is increasingly used for the diagnosis of these lesions as it is both minimally invasive and safe.
OBJECTIVE: To investigate the clinical efficacy of EBUS-TBNA in the diagnosis and differential diagnosis of mediastinal and hilar lesions.
METHODS: A retrospective observational study was undertaken to investigate patients diagnosed with mediastinal and hilar lymphadenopathy based on imaging at our hospital from 2020 to 2021. After evaluation, EBUS TBNA was used and data including the puncture site, postoperative pathology, and complications were recorded.
RESULTS: Data from 137 patients were included in the study, of which 135 underwent successful EBUS TBNA. A total of 149 lymph node punctures were performed, of which 90 punctures identified malignant lesions. The most common malignancies were small-cell lung carcinoma, adenocarcinoma, and squamous cell carcinoma. Forty-one benign lesions were identified, resulting from sarcoidosis, tuberculosis, and reactive lymphadenitis, amongst others. Follow-up findings showed that 4 cases were malignant tumors, with 1 case of pulmonary tuberculosis and 1 case of sarcoidosis). Four specimens where lymph node puncture was insufficient were subsequently confirmed by other means. The sensitivity of EBUS TBNA for malignant lesions, tuberculosis and sarcoidosis in mediastinal and hilar lesions was 94.7%, 71.4%, and 93.3%, respectively. Similarly, the negative predictive values (NPV) were 88.9%, 98.5%, and 99.2%, and the accuracy was 96.3%, 98.5%, and 99.3%.
CONCLUSIONS: EBUS TBNA is an effective and feasible approach for the diagnosis of mediastinal and hilar lesions that is minimally invasive and safe.