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首页> 外文期刊>Polish Archives of Internal Medicine >Usefulness of transbronchial needle aspiration for initial lung cancer staging
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Usefulness of transbronchial needle aspiration for initial lung cancer staging

机译：经支气管针吸对初次肺癌分期的作用

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INTRODUCTION: Besides radio logical methods (especially positron emission tomography combined with computed tomography), endoscopic techniques including transbronchial needle aspiration (TBNA) of mediastinal lymph nodes play an important role in lung cancer staging, thus having a significant effect on further patient management. OBJECTIVES: The aim of the study was to investigate the diagnostic value of blind TBNA in staging of lung cancer, using systematic mediastinal lymph node dissection (SLND) at thoracotomy as a confirmatory test. PATIENTS AND METHODS: Patients with lung cancer and enlarged mediastinal lymph nodes on computed tomography scans underwent TBNA. Non-small cell lung cancer (NSCLC) patients with negative TBNA or with single-level N2 disease underwent thoracotomy with appropriate pulmonary resection and with SLND. RESULTS: In 84 lung cancer patients, 166 TBNA were performed. Metastatic lymph node involvement was identified in 57 patients (67.9%). There were 10 patients (11.9%) with small cell lung cancer. Of the 74 NSCLC patients, TBNA revealed meta stases in 48 (64.9%). Twenty-four TBNA-negative patients (32.4%) and 4 patients (5.4%) with single-level N2 disease underwent pulmonary resection with SLND. In 8 of 28 operated patients (28.6%), N2 meta static nodes were identified. The per-patient analysis showed the sensitivity of TBNA to be 81.5%, specificity – 100%, accuracy – 86.5%, and negative predictive value (NPV) – 66.7%. CONCLUSIONS: Our results suggest that TBNA may be a useful method for initial NSCLC staging in patients suspected of N2-3 disease. Positive TBNA in 1 station only should not be considered as a true single-level N2 disease, because of a relatively low NPV for TBNA.
机译：简介：除了放射线方法（尤其是正电子发射断层扫描与计算机断层摄影相结合）之外，内镜技术包括纵隔淋巴结的经支气管针吸（TBNA）在肺癌分期中也起着重要作用，因此对进一步的患者管理具有重要影响。目的：本研究的目的是通过在开胸手术中使用系统性纵隔淋巴结清扫术（SLND）作为确证性试验，研究盲目的TBNA在肺癌分期中的诊断价值。病人和方法：计算机断层扫描的肺癌和纵隔淋巴结肿大的患者行TBNA检查。 TBNA阴性或单水平N2疾病的非小细胞肺癌（NSCLC）患者接受了适当的肺切除和SLND的开胸手术。结果：在84例肺癌患者中，进行了166例TBNA。在57例患者中发现了转移性淋巴结受累（67.9％）。有10例小细胞肺癌患者（11.9％）。在74例NSCLC患者中，TBNA显示48例（64.9％）出现了亚稳态。患有单水平N2疾病的24例TBNA阴性患者（32.4％）和4例（5.4％）接受了SLND肺切除。在28例手术患者中有8例（28.6％）中，发现了N2转移静态淋巴结。每位患者的分析显示，TBNA的敏感性为81.5％，特异性为100％，准确性为86.5％，阴性预测值（NPV）为66.7％。结论：我们的结果表明，TBNA可能是怀疑N2-3疾病患者初始NSCLC分期的有用方法。由于TBNA的NPV相对较低，因此不应仅将1个站中的TBNA阳性视为真正的单水平N2疾病。

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