摘要
【摘要】超声支气管镜引导经支气管针吸活检术（EBus-TBNA）可用于纵隔、肺门淋巴结和气道紧邻组织的活检。肺癌患者影像学淋巴结异常、EBUS-TBNA可获取标本时，指南推荐其为检查首选。EBUS-TBNA在胸部疾病的应用范围扩展到结节病、淋巴瘤和结核，在结节病早期诊断方面，其诊断率高于传统电子支气管镜。EBUS^TBNA标本可用于组织病理学、免疫组织化学、流式细胞学、免疫荧光原位杂交和染色体分析等检查。多向分析用于淋巴瘤、肺癌的进一步分型。分子表型分析，如表皮生长因子受体、间变性淋巴瘤激酶融合基因检测等，可用于指导肺癌分子靶向药物的选择。EBUS-TBNA微创、易重复操作的特点在肿瘤纵隔再分期中具有独特优势。随分子生物学技术的进步，肺癌基因检测尤为重要，EBUS-TBNA可提供理想标本。
Endobronchial ultrasound-guided transbronehial needle aspiration （EBUS-TBNA） is a biopsy method for sarhpling of mediastinal, hilar lymph nodes and pulmonary lesions adjacent to the airway. Guidelines suggest that EBUS-TBNA should be considered the first test of nodal staging for radiologically abnormal lymph nodes that are available by this approach. The application of EBUS-TBNA in thoracic diseases is expanding to the diagnosis of sarcoidosis, lymphoma, and tuberculosis. For early- stage sarcoidosis patients, EBUS-TBNA has a higher diagnostic rate compared to the traditional electronic bronchoscopy. The samples can be used for histopathological evaluation, immunohistochemistry, flow cytometry, fluorescence in situ hybridization, and chromosome analysis. Multidirectional analysis can help to identify the subtypes of lymphoma and lung cancer. Molecular phenotype analyses such as identification of epidermal growth factor receptor and anaplastic lymphoma kinase fusion gene detection can help to select molecular targeted therapeutic agents. The characteristics of EBUS-TBNA such as minimal invasion and repeatable operation have unique advantages in the restaging of mediastinum tumor. With the improvement of molecular biology technology, gene expression analysis will become important for lung cancer patients, and EBUS-TBNA can supply ideal tissues.
作者
张鹏
石荟
Zhang Peng;Shi Hui(Department of Respiratory Medicine, the Second Peoplels Hospital of Anhui Province, Hefei 230000, Chin)
出处
《国际呼吸杂志》
2018年第1期60-63,共4页
International Journal of Respiration
关键词
超声支气管镜
经支气管针吸活检
淋巴结
Endobronchial ultrasound
Transbronchial needle aspiration
Lymph node
