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首页> 外文期刊>Surgical Endoscopy >Utility and accuracy of endobronchial ultrasound as a diagnostic and staging tool for the evaluation of mediastinal adenopathy
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Utility and accuracy of endobronchial ultrasound as a diagnostic and staging tool for the evaluation of mediastinal adenopathy

机译：实用性和准确性作为评估纵隔腺病的诊断和分期工具的支气管内超声

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Background: Endobronchial ultrasound (EBUS) is an emerging technology for mediastinal evaluation which is less invasive than cervical mediastinoscopy, the traditional gold standard. The purpose of our study is to evaluate the utility and accuracy of EBUS as a diagnostic and staging tool at our regional teaching institution. Methods: We retrospectively reviewed the institutional thoracic surgery database for all patients undergoing EBUS between August, 2008 and March, 2011. Results: 190 patients underwent EBUS. 87 (46 %) patients underwent EBUS for diagnosis only; 73 (38 %) for staging only; and 30 (16 %) for both diagnosis and staging. Diagnoses obtained by diagnostic EBUS included non-small cell lung cancer - n = 36 (31 %); other cancer - n = 22 (19 %); sarcoid/granulomatous - n = 8 (7 %); benign lymphoid tissue - n = 50 (43 %); and was nondiagnostic in one case (1 %). For staging EBUS 53 (51 %) patients had benign lymph node tissue. 103 patients had a benign result at the time of EBUS. Fifty-six (54 %) of these patients underwent subsequent mediastinal lymph node dissection or mediastinoscopy for tissue confirmation with the remainder undergoing follow up surveillance chest CT scans. Two patients had a false negative EBUS. Both false negative studies sampled levels 4L, 4R, and 7. The overall false negative rate was 2 % for all benign results, and 4 % for those benign results confirmed with lymph node dissection or mediastinoscopy. The sensitivity and specificity of diagnostic EBUS was 97 and 100 %. The sensitivity and specificity for staging EBUS was 98 and 100 %. In those patients (n = 103) undergoing a staging EBUS, a mean of 2.6 nodal stations were sampled, with 59 % (n = 61) of these patients having three lymph node stations sampled and 33 % (n = 30) had two lymph node stations sampled. Conclusion: We found that EBUS is a highly accurate and minimally invasive manner in which to both diagnose mediastinal masses and stage the mediastinum.
机译：背景：支气管内超声（EBUS）是一种新兴的纵隔评估技术，其侵入性比传统的金标准宫颈纵隔镜检查低。我们研究的目的是评估EBUS作为区域教学机构诊断和分期工具的实用性和准确性。方法：我们回顾性回顾了2008年8月至2011年3月期间所有接受EBUS的患者的胸腔外科手术数据库。结果：190例患者接受了EBUS。 87例（46％）患者接受EBUS仅用于诊断; 73（38％）仅用于分期;诊断和分期均为30（16％）。通过诊断性EBUS获得的诊断包括非小细胞肺癌-n = 36（31％）;其他癌症-n = 22（19％）;肌瘤/肉芽肿-n = 8（7％）;良性淋巴组织-n = 50（43％）;一例（1％）无法诊断。对于EBUS 53分期（51％），患者具有良性淋巴结组织。 EBUS时有103例患者有良性结果。这些患者中的五十六名（54％）接受了随后的纵隔淋巴结清扫或纵隔镜检查以进行组织确认，其余患者接受了随访胸部CT扫描。两名患者的EBUS阴性。两项假阴性研究均采样了4L，4R和7级水平。所有良性结果的总假阴性率为2％，经淋巴结清扫或纵隔镜检查确认的良性结果为4％。诊断性EBUS的敏感性和特异性分别为97和100％。分期EBUS的敏感性和特异性分别为98和100％。在接受分期EBUS的患者（n = 103）中，平均采样了2.6个淋巴结，其中59％（n = 61）的患者采样了三个淋巴结，而33％（n = 30）的患者进行了两次淋巴结采样节点站采样。结论：我们发现EBUS是一种高度准确且微创的诊断纵隔肿块和纵隔分期的方法。

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