[ Objective ] To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the mediastinal staging of lung cancer. [Methods] 182 patients underwent EBUS-TBNA for known or suspected lung cancer were retrospectively reviewed. All the patients were detected enlarged mediastinal lymph nodes on radiographic examination of the chest (≥1.0 cm) and/or positron emission tomography (PET)-positive mediastinal lymph nodes. [Results] Of the 182 patients, 151 patients were found with N2 or N3 disease on EBUS-TBNA. 31 patients with negative EBUS-TBNA underwent thoracoscopy or thoracotomy for pulmonary resection and mediastinal lymph node dissection, 26 were confirmed by surgical biopsy, metastatic node was diagnosed in 5 patients. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of EBUS-TBNA for the mediastinal staging of lung cancer were 96.8%, 100%, 97.3%, 100%, and 83.9%, respectively.The procedure was uneventful, and there were no complications. [Conclusions] EBUS-TBNA is an effective and safe technique for mediastinal staging in lung cancer patients.%目的 探讨支气管内超声引导针吸活检术(EBUS-TBNA)在肺癌纵隔淋巴结分期中的应用价值.方法 回顾性总结2009年9月～2011年8月182例经EBUS-TBNA检查的肺癌患者的临床资料.术前所有患者胸部CT均发现纵隔淋巴结肿大(≥1.0 cm)和(或)PET/CT提示纵隔淋巴结阳性.结果 该组182例患者,经EBUS-TBNA检查证实纵隔淋巴结转移(阳性)者151例,未见纵隔淋巴结转移(阴性)者31例.阳性者放弃手术,予以化疗或新辅助治疗.阴性者接受胸腔镜或开胸手术,行肺叶切除或肺楔型切除加纵隔淋巴结清扫,术后病理证实26例纵隔淋巴结未见转移,5例纵隔淋巴结可见癌转移(EBUS-TBNA检查假阴性).EBUS-TB-NA的敏感性、特异性、准确性、阳性预测价值及阴性预测价值分别为96.8％(151/156),100％(26/26),97.3％(177/182),100％(151/151)和83.9％(26/31).所有患者检查耐受良好,无任何相关并发症发生.结论 E-BUS-TBNA是一种安全有效的肺癌纵隔淋巴结分期方法.
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