摘要
目的探讨支气管内超声引导针吸活检术(EBUS-TBNA)在肺门、纵膈淋巴结恶性肿瘤和结核诊断中的应用价值。方法回顾性分析2013年1月至2016年9月在四川大学华西医院呼吸内镜中心接受EBUSTBNA检查的553例患者的临床及病理资料,统计EBUS-TBNA对肺门、纵膈淋巴结肿瘤和结核的诊断敏感性、特异性和准确率。结果 EBUS-TBNA诊断肺门、纵膈淋巴结恶性肿瘤的敏感性、特异性和准确率分别为89.2%(263/295)、100.0%(247/247)和94.1%(510/542)。针吸活检组织查见肉芽肿诊断结核的敏感性、特异性和准确率分别为65.0%(76/117)、97.2%(385/396)和89.9%(461/513)。标本组织行抗酸染色和TB-PCR的102例中,查见抗酸杆菌或TB-PCR任一项阳性诊断结核的敏感性、特异性和诊断准确率为63.7%(58/91)、90.9%(10/11)和66.7%(68/102)。结论 EBUS-TBNA诊断肺门和纵膈肿瘤具有较高的敏感性和特异性,并可联合抗酸染色和TB-PCR联合诊断肺门和纵膈淋巴结结核。
Objective To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration （EBUS-TBNA） in diagnosing lung or mediastinal lymph node cancer and tuberculosis. Methods Clinical and pathological data of 553 patients who underwent EBUS-TBNA from January 2013 to September 2016 in West China Hospital of Sichuan University were reviewed. The sensitivity, specificity and accuracy of EBUS-＇TBNA for diagnosing lymph node tumor and tuberculosis of hilar and mediastinal lymph nodes were calculated. Results The sensitivity, specificity and accuracy of EBUS-TBNA in diagnosing hilar and mediastinal lymph node cancer were 89.2% （263/295）, 100% （247/247） and 94.1% （510/542）, respectively, compared with 70% （76/117）, 97.2% （385/396） and 89. 9% （461/513）, respectively, for diagnosing tuberculosis identified though granulomatous biopsy. In the 102 cases with acid fast staining and TB-PCR, 63.7% accuracy （58/91）, 90.9%（10/11） sensitivity and 66.7% （68/102） specificity were found for any positive findings from acid fast bacilli or TB-DNA. Conclusion EBUS-TBNA has high sensitivity and specificity for diagnosing hilar and mediastinal tumor, which can be used in combination with acid fast staining and TB-PCR for diagnosing tuberculosis.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2017年第3期347-351,共5页
Journal of Sichuan University(Medical Sciences)
基金
国家自然科学基金(No.81372504)
四川省科技厅项目(No.2016CZYD0001)资助
关键词
支气管内超声引导针吸活检术
肺门纵膈淋巴结
诊断
Endobronchial ultrasound-guided needle aspiration biopsy Lung or mediastinal lymphnodes Diagnosis
