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首页> 外文期刊>Annals of Thoracic Medicine >Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of non-lymph node thoracic lesions
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Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of non-lymph node thoracic lesions

机译：支气管内超声引导下经支气管针穿刺术对非淋巴结胸腔病变的诊断

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Aims: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has shown excellent diagnostic capabilities for mediastinal and hilar lymphadenopathy. However, its value in thoracic non-lymph node lesions is less clear. This study was designed to assess the value of EBUS-TBNA in distinguishing malignant from benign thoracic non-lymph node lesions. Methods: From October 2009 to August 2011, 552 patients underwent EBUS-TBNA under local anesthesia and with conscious sedation. We retrospectively reviewed 81 of these patients who had tracheobronchial wall-adjacent intrapulmonary or isolated mediastinal non-lymph node lesions. On-site cytological evaluation was not used. Immunohistochemistry (IHC) was performed to distinguish the origin or type of malignancy when necessary. Results: EBUS-TBNA was performed in 68 tracheobronchial wall-adjacent intrapulmonary and 13 isolated mediastinal non-lymph node lesions. Of the 81 patients, 77 (95.1%, 60 malignancies and 17 benignancies) were diagnosed through EBUS-TBNA, including 57 primary lung cancers, 2 mediastinal tumors, 1 pulmonary metastatic adenocarcinoma, 7 inflammation, 5 tuberculosis, 3 mediastinal cysts, 1 esophageal schwannoma, and 1 focal fibrosis. There were four false-negative cases (4.9%). Of the 60 malignancies, there were 9 (15.0%) which originally had no definite histologic origin or type. Thus, IHC was performed, with 7 (77.8%) being subsequently confirmed. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA in distinguishing malignant from benign lesions were 93.4% (60/64), 100% (17/17), 100% (60/60), 81.0% (17/21), and 95.1% (77/81), respectively. Conclusion: EBUS-TBNA is a safe procedure with a high sensitivity for distinguishing malignant from benign thoracic non-lymph node lesions within the reach of EBUS-TBNA, with IHC usually providing a more definitive diagnosis.
机译：目的：支气管内超声引导下经支气管针吸（EBUS-TBNA）对纵隔和肺门淋巴结病具有出色的诊断能力。然而，其在胸腔非淋巴结病变中的价值尚不清楚。这项研究旨在评估EBUS-TBNA在区分恶性和良性胸腔非淋巴结病变中的价值。方法：自2009年10月至2011年8月，在局部麻醉和清醒镇静的情况下，对552例患者进行了EBUS-TBNA治疗。我们回顾性研究了这些气管支气管壁相邻的肺内或孤立的纵隔非淋巴结病变的患者中的81例。没有使用现场细胞学评估。必要时进行免疫组织化学（IHC）以区分恶性肿瘤的起源或类型。结果：EBUS-TBNA在68例气管支气管壁邻近肺内和13例孤立的纵隔非淋巴结病变中进行。在81例患者中，通过EBUS-TBNA诊断出77例（95.1％，60例恶性肿瘤和17例良性肿瘤），包括57例原发性肺癌，2例纵隔肿瘤，1例肺转移性腺癌，7例炎症，5例肺结核，3例纵隔囊肿，1例食管神经鞘瘤和1局灶性纤维化。有四例假阴性病例（4.9％）。在60例恶性肿瘤中，有9例（15.0％）最初没有明确的组织学起源或类型。因此，进行了IHC，随后证实了7（77.8％）。 EBUS-TBNA区分恶性和良性病变的敏感性，特异性，阳性预测值，阴性预测值和准确性分别为93.4％（60/64），100％（17/17），100％（60/60），81.0 ％（17/21）和95.1％（77/81）。结论：EBUS-TBNA是一种安全的方法，具有很高的灵敏度，可将EBUS-TBNA范围内的恶性与良性胸腔非淋巴结病变区分开，IHC通常可提供更明确的诊断。

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