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目的评价经支气管镜淋巴结针吸活检(TBNA)在纵隔肺门肿大淋巴结诊断中的作用。方法对CT检查发现纵隔肺门淋巴结肿大,但估计支气管镜检查不能发现气管或支气管内新生物的77例患者,在支气管镜检查过程中完成TBNA操作,直接涂片送检。结果38例诊断为肺癌,35例诊断为肺部良性疾病,4例最终无明确诊断。77例患者共穿刺128个部位,225针,其中TBNA穿刺成功222针(98．7％)。35例肺部良性疾病的TBNA总结果均为阴性。38例肺癌患者中, TBNA总结果阳性31例(81．6％),其中9例患者TBNA涂片为惟一病理学证据。38例肺癌患者共穿刺63个淋巴结,其中TBNA结果阳性41例(65．1％)。TBNA结果的阳性率与病理类型和淋巴结大小有关。TBNA不良反应很少,52例(67．5％)患者穿刺部位少量出血。结论TBNA安全性好,对肺癌的诊断和分期判定有很大帮助,但对肺部良性疾病的诊断帮助不大。
Objective To evaluate the role of bronchial needle aspiration biopsy (TBNA) in the diagnosis of enlarged mediastinal hilar lymph nodes. Methods Tumors of the mediastinum and hilar lymph nodes were found on the CT scan. However, it was estimated that 77 patients with bronchial or bronchial neoplasms were not found by bronchoscopy. TBNA procedures were performed during bronchoscopy and direct smear was performed. Results 38 cases were diagnosed as lung cancer, 35 cases diagnosed as benign lung diseases, 4 cases without definite diagnosis. A total of 77 patients were punctured 128 sites, 225 needles, of which 222 needle (98.7%) was successful in TBNA puncture. Twenty-five patients with benign pulmonary diseases had negative TBNA results. Of the 38 patients with lung cancer, 31 were positive for TBNA (81.6%), of which 9 were TBNA smears as the only pathological evidence. Totally 63 lymph nodes were punctured in 38 patients with lung cancer, of which 41 (65.1%) were positive for TBNA. The positive rate of TBNA was related to pathological type and lymph node size. Adverse reactions to TBNA were rare, with a small amount of bleeding in the puncture site of 52 patients (67.5%). Conclusion The safety of TBNA is very good for the diagnosis and staging of lung cancer. However, the diagnosis of benign lung diseases is not helpful.