EBUS 引导下的冷冻生物切片检查在胸腔疾病诊断中的应用

IF 10.4 2区医学 Q1 RESPIRATORY SYSTEM

Pulmonology Pub Date : 2024-09-01 DOI:10.1016/j.pulmoe.2023.11.008

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引用次数: 0

摘要

背景支气管内超声（EBUS）已成为诊断胸腔内疾病，尤其是肺癌分期的重要工具。目的研究 EBUS-经支气管纵隔冷冻活检术（EBUS-TMC）与 EBUS-经支气管针吸术（TBNA）相比，对多种胸腔内疾病的诊断率和安全性。方法对2021年8月至2023年10月期间同时接受EBUS-TBNA和支气管内超声-经支气管纵隔低温活检（EBUS-TMC）的48例患者进行了单中心回顾性观察研究。结果 EBUS-TMC 的总体诊断率超过了 EBUS-TBNA（95.8% vs 54.1%），尤其在诊断肉样瘤病（92.8% vs 78.5%）、罕见纵隔疾病（100% vs 0%）、增生性淋巴腺病（100% vs 0%）和淋巴增生性疾病（100% vs 0%）方面表现突出。在 NSCLC 和 SCLC 的诊断中未发现明显差异。结论EBUS-TMC有助于纵隔疾病，尤其是淋巴瘤和罕见纵隔肿瘤的精确诊断和亚型分类，从而减少非诊断性手术的数量。

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EBUS-guided cryobiopsy in the diagnosis of thoracic disorders

Background

Endobronchial Ultrasound (EBUS) has emerged as a crucial tool for diagnosing intrathoracic disorders, particularly in the staging of lung cancer. However, its diagnostic capabilities in the context of benign and rare diseases remain a subject of debate.

Aim

to investigate the diagnostic yield and safety of EBUS-transbronchial mediastinal cryobiopsy (EBUS-TMC) in comparison to EBUS-transbronchial needle aspiration (TBNA) for a broad spectrum of intrathoracic diseases.

Methods

a single-centre retrospective observational study conducted on 48 patients who underwent both EBUS-TBNA and endobronchial ultrasound-transbronchial mediastinal cryobiopsy (EBUS-TMC) in the same procedure between August 2021 and October 2023.

Results

The overall diagnostic yield of EBUS-TMC surpassed that of EBUS-TBNA (95.8% vs 54.1 %), notably excelling in the diagnosis of sarcoidosis (92.8% vs 78.5 %), rare mediastinal disorders (100% vs 0 %), hyperplastic lymphadenopathy (100% vs 0 %), and lymphoproliferative disease (100% vs 0 %). No significant differences were observed in the diagnosis of NSCLC and SCLC. Samples obtained through EBUS-TMC facilitated the acquisition of NGS and immunohistochemical analyses more readily.

Conclusion

EBUS-TMC may contribute to the precise diagnosis and subtyping of mediastinal diseases, especially lymphomas and rare mediastinal tumors, thereby reducing the number of non-diagnostic procedures.

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来源期刊

Pulmonology Medicine-Pulmonary and Respiratory Medicine

CiteScore

14.30

自引率

5.10%

发文量

159

审稿时长

19 days

期刊介绍： Pulmonology (previously Revista Portuguesa de Pneumologia) is the official journal of the Portuguese Society of Pulmonology (Sociedade Portuguesa de Pneumologia/SPP). The journal publishes 6 issues per year and focuses on respiratory system diseases in adults and clinical research. It accepts various types of articles including peer-reviewed original articles, review articles, editorials, and opinion articles. The journal is published in English and is freely accessible through its website, as well as Medline and other databases. It is indexed in Science Citation Index Expanded, Journal of Citation Reports, Index Medicus/MEDLINE, Scopus, and EMBASE/Excerpta Medica.