TBNA联合经皮纵隔淋巴结穿刺在原发性肺癌纵隔淋巴结分期中应用价值.docVIP

TBNA联合经皮纵隔淋巴结穿刺在原发性肺癌纵隔淋巴结分期中应用价值 　　[摘要] 目的 探?经支气管镜针吸活检术（transbronchial needle aspiration biopsy，TBNA）联合经皮纵隔淋巴结穿刺在原发性肺癌早期纵隔淋巴结分期中的应用价值和安全性分析。 方法 收集我院2013年1月～2016年10月期间以原发性肺癌首诊的患者共60例，根据肺部增强CT纵隔淋巴结情况（短径1.0 cm），将患者分为A组、B组和C组，A组行纵隔淋巴结TBNA，B组行经皮纵隔淋巴结穿刺，C组行TBNA联合经皮纵隔淋巴结穿刺，穿刺标本行病理及免疫组化检测，比较两种方法的穿刺阳性率，同时观察患者情况，进行安全性分析。 结果 通过对60例患者纵隔淋巴结穿刺标本病理及免疫组化检测，TBNA明确鳞癌4例，腺癌2例，小细胞癌1例，穿刺阳性率为35.0%；经皮纵隔淋巴结穿刺明确鳞癌3例，腺癌2例，腺鳞癌1例，穿刺阳性率为30.0%；TBNA联合经皮纵隔淋巴结穿刺明确鳞癌5例，腺癌4例，腺鳞癌2例，小细胞癌1例，大细胞癌1例，低分化神经内分泌癌1例，穿刺阳性率为70.0%；TBNA联合经皮纵隔淋巴结穿刺在穿刺阳性率方面均高于TBNA组和经皮纵隔淋巴结穿刺组，差异有统计学意义（P 1.0 cm） in the enhanced CT of lung， the patients were divided into group A， group B and group C. Group A was given mediastinal lymph node TBNA， and group B was treated with percutaneous mediastinal lymph node aspiration， and group C was treated with TBNA combined with percutaneous mediastinal lymph node aspiration. Puncture specimens were examined by pathology and immunohistochemistry. The positive biopsy rate of the two methods was compared，and meanwhile the patient’s condition was observed. And the safety analysis was performed. Results Through the pathology and immunohistochemical examination of 60 cases of mediastinal lymph node aspiration specimen， there were 4 cases of squamous cell carcinoma， 2 cases of adenocarcinoma and 1 case of small cell carcinoma conformed by TBNA， with the positive biopsy rate of 35.0%. The percutaneous mediastinal lymph node aspiration showed that there were 3 cases of squamous cell carcinoma， 2 cases of adenocarcinoma and 1 case of adenosquamous carcinoma， with the positive biopsy rate of 30.0%. TBNA combined with percutaneous mediastinal lymph node aspiration conformed that there were 5 cases of squamous cell carcinoma， 4 cases of adenocarcinoma， 2 cases of adenosquamous， 1 case of small cell carcinoma，1 case of large cell carcinoma and 1 case of poorly differentiated neuroendocrine carcinoma.and the positive biopsy rate was 70.0%. The positive biopsy rate of TBNA combined with percutaneous mediastin