超声内镜引导下经支气管针吸活检术在肺及纵隔疾病诊断中的应用

发布时间：2018-10-16 19:41

【摘要】：目的探讨超声支气管镜引导下经支气管针吸活检术(EBUS-TBNA)在肺及纵隔疾病中的诊断价值。方法对50例经胸部CT发现肺门-纵隔淋巴结肿大和(或)气管、支气管旁肿物而行EBUS-TBNA患者的临床资料进行回顾性分析,计算其诊断肺及纵隔病变的敏感度、特异度和准确度。结果 50例患者中明确诊断44例,包括恶性病变36例,良性病变8例,其中诊断纵隔淋巴结结核3例、结节病3例、临床诊断为慢性非特异性炎症2例。共穿刺67组淋巴结或肿块,每组平均穿刺2~4针。EBUS-TBNA对肺及纵隔恶性肿瘤诊断的敏感度、特异度和准确度分别为92.3%、100%和94%,阳性预测值和阴性预测值分别为100%和78.6%。EBUS-TBNA对纵隔及肺内病变的诊断敏感度为88%,特异度为100%。患者均未出现严重并发症。结论 EBUS-TBNA在肺及纵隔恶性肿瘤及不明原因肺门-纵隔淋巴结肿大等疾病诊断方面有较高的敏感度、特异度和准确度,且并发症少。
[Abstract]:Objective to evaluate the diagnostic value of transbronchial needle aspiration (EBUS-TBNA) guided by ultrasound bronchoscope in lung and mediastinal diseases. Methods the clinical data of 50 EBUS-TBNA patients with hilar and mediastinal lymphadenopathy and / or trachea or paracranchial mass found by CT were analyzed retrospectively. The sensitivity, specificity and accuracy of the diagnosis of pulmonary and mediastinal lesions were calculated. Results 44 cases of 50 patients were diagnosed, including 36 malignant lesions and 8 benign lesions, including 3 cases of mediastinal lymph node tuberculosis, 3 cases of sarcoidosis and 2 cases of chronic nonspecific inflammation. A total of 67 groups of lymph nodes or masses were punctured. The sensitivity of EBUS-TBNA to diagnosis of lung and mediastinal malignancy was observed. The specificity and accuracy were 92. 3% and 94% respectively. The positive predictive value and negative predictive value were 100%. The sensitivity and specificity of 78.6%.EBUS-TBNA in diagnosing mediastinal and pulmonary lesions were 88 and 100 respectively. None of the patients had serious complications. Conclusion EBUS-TBNA has high sensitivity, specificity and accuracy in the diagnosis of lung and mediastinal malignant tumors and unknown pulmonary hilar and mediastinal lymphadenopathy, and has fewer complications.
【作者单位】：山东大学第二医院;
【基金】：山东省科技发展计划项目(2014GSF118116)
【分类号】：R56

【相似文献】