Background and objective: It has been proven that endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was a new minimally invasive method in the diagnosis for mediastinal lymph nodes. The aim of this study is to evaluate the diagnostic and staging yield of EBUS-TBNA for lung cancer.
Methods: Seventy-five patients with tumors and enlarged mediastinal lymph nodes found by CT underwent the diagnosis by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) from April 1, 2009 to Febuary 8, 2010. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EBUS-TBNA were evaluated.
Results: Seventy-five patients with 177 lymph node groups (2.4 groups in average) were studied. Histopathological samples were found in 49.33% patients and in 28.81% groups. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EBUS-TBNA for diagnostic were 98.43%, 100.00%, 100.00%, 91.67% and 98.66%, respectively, in per patient analysis and were 95.10%, 100%, 100.00%, 82.93%, and 96.05%, respectively, in per group analysis, higher than CT examination (P < 0.05) expect for sensitivity (P = 0.435). Staging changed in 19 (26.03%) patients after EBUS-TBNA.
Conclusion: EBUS-TBNA proved to be a safe procedure with a high yield for the diagnosis of lung cancer.
背景与目的: 经支气管超声引导针吸活检（endobronchial ultrasound-guided transbronchial needle aspiration, EBUS-TBNA）是近年来新的纵隔淋巴结定性诊断方法。本研究旨在探讨其应用于肺癌诊断及分期中的价值。
方法: 2009年4月1日-2010年2月8日，75例本院胸部增强CT提示肺内占位伴多发纵隔淋巴结肿大患者接受EBUS-TBNA检查。以最终病理诊断为金标准，检验EBUS-TBNA诊断肺癌纵隔淋巴结转移的准确性、敏感性、特异性、阳性及阴性预测值，并判断其用于非小细胞肺癌N分期的准确率。
结果: 75例患者共计穿刺177组病灶区域，平均穿刺2.4组/例。75例患者，组织病理标本送检率为49.33%。以177组穿刺区域计算，组织病理标本送检率为28.81%。75例患者EBUS-TBNA诊断准确率为98.66%，敏感性为98.43%，特异性为100.00%，阳性预测值为100.00%，阴性预测值为91.67%。以177组穿刺区域计算EBUS-TBNA诊断准确率为96.05%，敏感性为95.10%，特异性为100.00%，阳性预测值为100.00%，阴性预测值为82.93%。上述指标除敏感性（P=0.435）外，均高于CT检查（P < 0.05）。73例可行N分期患者中，19例（26.03%）患者EBUS-TBNA检查后出现分期改变。
结论: EBUS-TBNA准确率较高，创伤小，是用于肺癌诊断及分期的较好方法。