经支气管镜针吸活检术在纵膈占位病变中的临床应用价值

doi:10.3969/j.issn.1674-490X.2015.05.003

医学研究与教育 ›› 2015, Vol. 32 ›› Issue (5): 10-13.DOI: 10.3969/j.issn.1674-490X.2015.05.003

经支气管镜针吸活检术在纵膈占位病变中的临床应用价值

杨泽西¹，张泽明²，安蕾¹，李翔云¹

1. 河北大学，河北保定 071000；2. 河北大学附属医院呼吸科，河北保定 071000

出版日期:2015-10-25 发布日期:2015-10-25
通讯作者: 张泽明（1964—），男，河北献县人，主任医师，教授，博士，硕士生导师，主要从事呼吸系统疾病研究。E-mail: zhangzemingwang@sohu.com
作者简介:杨泽西（1989—），男，河北保定人，医师，在读硕士，从事肺结核疾病研究。E-mail: yangzexi@163.com

Clinical value of transbronehial needle aspiration in the diagnosis of mediastinal occupied lesions

YANG Zexi¹, ZHANG Zeming², AN Lei¹, LI Xiangyun¹

1. Hebei University, Baoding 071000, China 2. Department of Respiratory Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China

Online:2015-10-25 Published:2015-10-25

摘要/Abstract

摘要： 目的探讨当前支气管镜针吸活检术（transbronchial needle aspiration，TBNA）在纵膈占位病变诊断价值。方法回顾性分析总结 2013 年 7 月至 2014 年 10 月河北大学附属医院 68 例患者经 CT 扫描发现纵膈占位，接受支气管镜针吸活检术检查后的临床资料。结果所研究的患者，在常规支气管镜下有 22 例获得诊断，其中恶性病变 16 例，良性病变 6 例，确诊率 32.35％(22/68)；经 TBNA 检查后 57 例获得诊断，其中恶性病变 42 例，良性病变 15 例，确诊率 83.82％(57/68)。TBNA在纵膈占位病变良恶性诊断和鉴别诊断方面的敏感性、特异性和准确性分别为95.45％(42/44)，62.5%(15/24) 和83.82%(57/68)。所有患者检查耐受良好，有 2 例出现了少量出血，给予对症止血治疗。结论在新技术快速发展的今天，对于纵膈占位病变，TBNA 目前仍然是一种安全、有效的诊断及鉴别诊断方法。

关键词: 支气管镜检查, 针吸活组织检查, 纵膈占位病变

Abstract: Objective Objective To evaluate the value of transbronehial needle aspiration(TBNA)in the diagnosis of mediastinal occupied lesions. Methods A retrospective study was conducted in 68 consecutive patients with mediastinal occupied lesions. The patients underwent TBNA by using a flexible bronchoscope from July 2013 to October 2014. Results In all patients, the diagnostic rate was 32.35% by routine bronchoscopy(22/68), and TBNA achieved definitive diagnoses in 57 patients (83.82%). The sensitivity, specificity, accuracy of TBNA in distinguishing malignant mediastinal lesions were 95.45%(42/44), 62.5%(15/24) and 83.82%(57/68) respectively. EBUS was well tolerated by all of the patients, and 2 patients showed bleeding a little at the puncture site, who did not need special treatment. Conclusion With the rapid developments of new technology, the TBNA of mediastinal occupied lesions is still a minimally invasive and safe diagnostic technique.

Key words: bronchoscopy, needle biopsy, mediastinal occupied lesions

中图分类号:

杨泽西，张泽明，安蕾，李翔云. 经支气管镜针吸活检术在纵膈占位病变中的临床应用价值[J]. 医学研究与教育, 2015, 32(5): 10-13.

YANG Zexi, ZHANG Zeming, AN Lei, LI Xiangyun. Clinical value of transbronehial needle aspiration in the diagnosis of mediastinal occupied lesions[J]. Medical Reserch and Education, 2015, 32(5): 10-13.

参考文献

[1] MUHANNED A H, YASER E S, KATHLEEN E, et al. Linear probe endobronchial ultrasound bronchoscopy with guided transbronchial needle aspiration (EBUS-TBNA) in the evaluation of mediastinal and hilar pathology: introducing the procedure to a teaching institution[J]. Lung, 2013, 191(1): 109-115.
[2] WANG K P. Staging of bronchogenic carcinoma by bronchoscopy[J]. Chest, 1994, 106(2): 588-593.
[3] MANSER R L, IEVIRG L B, BYMES G, et al. Screening for lung cancer: a systematic review and mata-analysis of controlled trials[J]. Thorax, 2003, 58(9): 784-789.
[4] YASUFUKU K, NAKAJIMA T, FUJIWARA T, et al. Role of endobronchial ultrasound-guided transbronchial needle aspiration in the management of lung cancer[J]. Gen Thornc Cardiovasc Stag, 2008, 56(6): 268-276.
[5] HENNINGER B, PUTZER D, KENDLER D, et al. Diagnostic value of softwarebased image fusion of computed tomography and F18-FDG PET scans in patients with malignant lymphoma[J]. The Scientific World Journal, 2012, 2012: 821694.
[6] MARIANNE M, SLOET O O, GUY C M, et al. Equine sarcoidosis: clinical signs, diagnosis, treatment and outcome of 22 cases[J]. Veterinary Dermatology, 2013, 24(1): 218-224, e48.
[7] SUN J, TENG J, YANG H, et al. Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing intrathoracic tuberculosis[J]. Ann Thorac Surg, 2013, 96(6): 2021-2027.
[8] KATCHANOV J U, ZIMMERMANN G, BRANDING K, et al. HIV-associated multicentric Castleman's disease after initiation of antiretroviral therapy: experience of a European centre[J]. Infection, 2014, 42(4): 791-793.
[9] ELIF K, LEYLA M, TUGCE S O, et al. Transbronchial needle aspiration“by the books”[J]. Annals of Thoracic Medicine, 2011, 6(2): 85-90.
[10] TOLOZA E M, HARPOLE L, DETTERBECK F, et al. Invasive staging of non-small cell lung cancer a review of the current evidence[J]. Chest, 2003, 123(1Suppl): 157-166.
[11] AKASH V, KYEONGMAN J, WONJUNG K, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of central lung parenchymal lesions[J]. Yonsei Medical Journal, 2013, 54(3): 672-678.
[12] GURIOL C, RAVAGLIA C, ROMAGNOLI M, et al. EBUS-TBNA in mediasinal/hilar lymphadenopathies and/or masses an Italian case series[J]. Clin Respir J, 2012, 6(1): 3-8.
[13] YASUFUKU K, NAKAJIMA T, FUJIWARA T, et al. Utility of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal masses of unknown etiology[J]. Ann Thorac Surg, 2011, 9l(3): 831-836.
[14] HERH F J, EBERHANRDT R, KRASNIK M, et a1. Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes in the radiologically and positron emission tomography-normal mediastinum in patients with lung cancer[J]. Chest, 2008, 133(4): 887-891.
[15] PARK J S, CHUNG J H, JHEON S, et al. EBUS-TBNA in the differential diagnosis of pulmonary artery sarcoma and thromboembolism[J]. Eur Respir, 2011, 38(6): 1480-1482.

经支气管镜针吸活检术在纵膈占位病变中的临床应用价值

Clinical value of transbronehial needle aspiration in the diagnosis of mediastinal occupied lesions

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