超声支气管镜引导下经支气管壁针吸活检术在非小细胞肺癌淋巴结系统性评价及可切除性分析中的作用
目的 探讨在超声支气管镜引导下经支气管壁针吸活检术( EBUS?TBNA)对非小细胞肺癌(NSCLC)患者淋巴结分期的评价以及对手术可切除性评估的影响.方法 收集2015年3月至2018年12月,在中国科学院大学宁波华美医院接受EBUS?TBNA的NSCLC患者154例.应用EBUS?TBNA系统性地对所有可及的纵隔和肺门淋巴结进行探查及穿刺.比较EBUS?TBNA和增强CT作为术前淋巴结分期和可切除性评价的效果.结果 154例NSCLC患者成功穿刺475组淋巴结,EBUS?TBNA的灵敏度、特异度和准确率分别为 94.2%、100.0%和 96.0%,而 CT 分别为 89.9%、31.8%...
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| Published in | 中华肿瘤杂志 Vol. 41; no. 10; pp. 792 - 795 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
中国科学院大学宁波华美医院呼吸及危重症科315010
01.10.2019
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0253-3766 |
| DOI | 10.3760/cma.j.issn.0253-3766.2019.10.013 |
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| Abstract | 目的 探讨在超声支气管镜引导下经支气管壁针吸活检术( EBUS?TBNA)对非小细胞肺癌(NSCLC)患者淋巴结分期的评价以及对手术可切除性评估的影响.方法 收集2015年3月至2018年12月,在中国科学院大学宁波华美医院接受EBUS?TBNA的NSCLC患者154例.应用EBUS?TBNA系统性地对所有可及的纵隔和肺门淋巴结进行探查及穿刺.比较EBUS?TBNA和增强CT作为术前淋巴结分期和可切除性评价的效果.结果 154例NSCLC患者成功穿刺475组淋巴结,EBUS?TBNA的灵敏度、特异度和准确率分别为 94.2%、100.0%和 96.0%,而 CT 分别为 89.9%、31.8%和72.0%,差异均有统计学意义(均P＜0.05).在短径≤15 mm的淋巴结中,EBUS?TBNA的灵敏度、特异度和准确率分别为92.4%、100.0%和96.0%,而CT分别为80.7%、34.8%和60.1%,差异均有统计学意义(均P＜0.05).有62例患者的淋巴结分期发生改变,分期进展27例,改善35例,其中32例患者手术可切除性发生改变. EBUS?TBNA判断手术可切除性与依据病理结果对手术可切除性评估的一致性Kappa系数为0.95,灵敏度为100.0%,特异度为97.2%.结论 应用EBUS?TBNA系统性评价NSCLC患者淋巴结的转移情况,能够提高NSCLC患者术前淋巴结分期和手术可切除性评估的准确性. |
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| AbstractList | 目的 探讨在超声支气管镜引导下经支气管壁针吸活检术( EBUS?TBNA)对非小细胞肺癌(NSCLC)患者淋巴结分期的评价以及对手术可切除性评估的影响.方法 收集2015年3月至2018年12月,在中国科学院大学宁波华美医院接受EBUS?TBNA的NSCLC患者154例.应用EBUS?TBNA系统性地对所有可及的纵隔和肺门淋巴结进行探查及穿刺.比较EBUS?TBNA和增强CT作为术前淋巴结分期和可切除性评价的效果.结果 154例NSCLC患者成功穿刺475组淋巴结,EBUS?TBNA的灵敏度、特异度和准确率分别为 94.2%、100.0%和 96.0%,而 CT 分别为 89.9%、31.8%和72.0%,差异均有统计学意义(均P＜0.05).在短径≤15 mm的淋巴结中,EBUS?TBNA的灵敏度、特异度和准确率分别为92.4%、100.0%和96.0%,而CT分别为80.7%、34.8%和60.1%,差异均有统计学意义(均P＜0.05).有62例患者的淋巴结分期发生改变,分期进展27例,改善35例,其中32例患者手术可切除性发生改变. EBUS?TBNA判断手术可切除性与依据病理结果对手术可切除性评估的一致性Kappa系数为0.95,灵敏度为100.0%,特异度为97.2%.结论 应用EBUS?TBNA系统性评价NSCLC患者淋巴结的转移情况,能够提高NSCLC患者术前淋巴结分期和手术可切除性评估的准确性. |
| Abstract_FL | Objective To evaluate the role of endobronchial ultrasound guided transbronchial needle aspiration (EBUS?TBNA) in lymph node staging and resectability assessment of patients with non?small cell lung cancer (NSCLC). Methods The clinical data of 154 patients with NSCLC who underwent EBUS?TBNA from March 2015 to December 2018 were collected. All accessible mediastinal and hilar lymph nodes were systematically explored and punctured using EBUS?TBNA. EBUS?TBNA and CT were used for preoperative staging and resectability evaluation.Results The sensitivity, specificity and accuracy of EBUS?TBNA were 94.2%, 100.0% and 96.0%, respectively, while those of CT were 89.9%, 31.8% and 72.0%, respectively.The differences were statistically significant (P＜0.05).The sensitivity, specificity and accuracy of EBUS?TBNA in lymph nodes with short diameter less than 15 mm were 92.4%, 100.0% and 96.0%, respectively, while those of CT were 80.7%, 34.8% and 60.1%, respectively, with statistical differences (P＜0.05). The staging of 62 patients was changed, 27 cases were up?regulated and 35 cases were down?regulated. Among them, 32 cases had been changed to resectable. The evaluating resectability of EBUS?TBNA showed excellent consistency with that of pathological results ( Kappa＝0.95). The sensitivity and specificity were 100.0% and 97.2%, respectively. Conclusion EBUS?TBNA can systemically evaluate the metastatic status of NSCLC patients and improve the accuracy of preoperative lymph node staging and resectability assessment. |
| Author | 陈静璐 胡晓维 叶振悦 杜学奎 赵伟和 邹俊勇 |
| AuthorAffiliation | 中国科学院大学宁波华美医院呼吸及危重症科315010 |
| AuthorAffiliation_xml | – name: 中国科学院大学宁波华美医院呼吸及危重症科315010 |
| Author_FL | Chen Jinglu Hu Xiaowei Zou Junyong Zhao Weihe Ye Zhenyue Du Xuekui |
| Author_FL_xml | – sequence: 1 fullname: Zou Junyong – sequence: 2 fullname: Zhao Weihe – sequence: 3 fullname: Chen Jinglu – sequence: 4 fullname: Du Xuekui – sequence: 5 fullname: Hu Xiaowei – sequence: 6 fullname: Ye Zhenyue |
| Author_xml | – sequence: 1 fullname: 邹俊勇 – sequence: 2 fullname: 赵伟和 – sequence: 3 fullname: 陈静璐 – sequence: 4 fullname: 杜学奎 – sequence: 5 fullname: 胡晓维 – sequence: 6 fullname: 叶振悦 |
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| DocumentTitle_FL | The role of EBUS?TBNA in the systematic evaluation of lymph node staging and resectability analysis in non?small cell lung cancer |
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| Keywords | Resectability Lymph node staging 可切除性 超声支气管镜 淋巴结分期 Carcinoma,non?small?cell lung Endobronchial ultrasound guided transbronchial needle aspiration 非小细胞肺癌 系统性评价 Systematic evaluation |
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