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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 investigate the value of EBUS-TBNA in the diagnosis of hilar, mediastinal lymph node and tuberculosis. Methods The clinical and pathological data of 553 patients undergoing EBUSTBNA examination at the Respiratory Endoscopy Center of West China Hospital of Sichuan University from January 2013 to September 2016 were retrospectively analyzed. The clinical data of EBUS-TBNA on hilar, mediastinal lymph nodes and tuberculosis Diagnose sensitivity, specificity and accuracy. Results The sensitivity, specificity and accuracy of EBUS-TBNA for the diagnosis of hilar and mediastinal lymph node malignancies were 89.2% (263/295), 100.0% (247/247) and 94.1% (510/542), respectively. Sensitivity, specificity and accuracy of needle biopsy in detecting granuloma were 65.0% (76/117), 97.2% (385/396) and 89.9% (461/513), respectively. The sensitivity, specificity and diagnostic accuracy of any of the 102 cases diagnosed with acid-fast bacilli or TB-PCR were 102.7% (58/91), 90.9 % (10/11) and 66.7% (68/102). Conclusion EBUS-TBNA has high sensitivity and specificity in the diagnosis of hilar and mediastinal tumors, and combined with acid-fast staining and TB-PCR in the diagnosis of hilar and mediastinal lymph node tuberculosis.