摘要
目的探讨经支气管镜针吸活检术(transbronchial needle aspiration biopsy,TBNA)联合经皮纵隔淋巴结穿刺在原发性肺癌早期纵隔淋巴结分期中的应用价值和安全性分析。方法收集我院2013年1月~2016年10月期间以原发性肺癌首诊的患者共60例,根据肺部增强CT纵隔淋巴结情况(短径>1.0 cm),将患者分为A组、B组和C组,A组行纵隔淋巴结TBNA,B组行经皮纵隔淋巴结穿刺,C组行TBNA联合经皮纵隔淋巴结穿刺,穿刺标本行病理及免疫组化检测,比较两种方法的穿刺阳性率,同时观察患者情况,进行安全性分析。结果通过对60例患者纵隔淋巴结穿刺标本病理及免疫组化检测,TBNA明确鳞癌4例,腺癌2例,小细胞癌1例,穿刺阳性率为35.0%;经皮纵隔淋巴结穿刺明确鳞癌3例,腺癌2例,腺鳞癌1例,穿刺阳性率为30.0%;TBNA联合经皮纵隔淋巴结穿刺明确鳞癌5例,腺癌4例,腺鳞癌2例,小细胞癌1例,大细胞癌1例,低分化神经内分泌癌1例,穿刺阳性率为70.0%;TBNA联合经皮纵隔淋巴结穿刺在穿刺阳性率方面均高于TBNA组和经皮纵隔淋巴结穿刺组,差异有统计学意义(P<0.05)。所有患者穿刺均耐受良好,未出现严重并发症。结论 TBNA联合经皮纵隔淋巴结穿刺在原发性肺癌纵隔淋巴结中活检阳性率明显高于单用TBNA或者经皮纵隔淋巴结穿刺,并且无严重不良反应,在原发性肺癌纵隔淋巴结分期中安全、有效。
Objective To investigate the value and safety of transbronchial needle aspiration biopsy（TBNA） combined with percutaneous mediastinal lymph node aspiration in mediastinal lymph node staging of primary lung cancer in the early stage. Methods A total of 60 patients firstly diagnosed with primary lung cancer in our hospital from January 2013 to October 2016 were collected. According to the situation of mediastinal lymph node （short diameter〉 1.0 cm） in the enhanced CT of lung, the patients were divided into group A, group B and group C. Group A was given mediastinal lymph node TBNA, and group B was treated with percutaneous mediastinal lymph node aspiration, and group C was treated with TBNA combined with percutaneous mediastinal lymph node aspiration. Puncture specimens were examined by pathology and immunohistochemistry. The positive biopsy rate of the two methods was compared,and meanwhile the patient＇s condition was observed. And the safety analysis was performed. Results Through the pathology and immuno- histochemical examination of 60 cases of mediastinal lymph node aspiration specimen, there were 4 cases of squamous cell carcinoma, 2 cases of adenocarcinoma and 1 case of small cell carcinoma conformed by TBNA, with the positive biopsy rate of 35.0%. The percutaneous mediastinal lymph node aspiration showed that there were 3 cases of squamous cell carcinoma, 2 cases of adenocarcinoma and 1 case of adenosquamous carcinoma, with the positive biopsy rate of 30.0%. TBNA combined with percutaneous mediastinal lymph node aspiration conformed that there were 5 cases of squamous cell carcinoma, 4 cases of adenocarcinoma, 2 cases of adenosquamous, 1 case of small cell carcinoma,1 case of large cell carcinoma and 1 case of poorly differentiated neuroendocrine carcinoma.and the positive biopsy rate was 70.0%. The positive biopsy rate of TBNA combined with percutaneous mediastinal lymph node aspiration was higher than TBNA group and percutaneous mediastinal lymph node aspiration group,and the difference was st
出处
《中国现代医生》
2017年第9期5-8,共4页
China Modern Doctor
基金
浙江省嘉兴市科技计划项目(公益类)(2015AY23011)
关键词
原发性肺癌
纵隔淋巴结
经支气管镜针吸活检术
经皮穿刺活检
分期
Primary lung cancer
Mediastinal lymph nodes
Transbronchial needle aspiration biopsy
Percutaneous biopsy
Staging
