Application Value of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in Diagnosis of Space-occupying Lesions of Lung and Mediastinum

Lu YAO; Hui TAN; Yong-hua RUAN; Zhong-yi QIAN; Zhi-hong YANG; Rui RUAN; Qi-ying ZHANG; Ming-ting ZHOU; Xing-yin FANG

doi:10.12259/j.issn.2095-610X.S20210311

Volume 42 Issue 3

Apr. 2021

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2021 > 42(3): 41-48

Lu YAO, Hui TAN, Yong-hua RUAN, Zhong-yi QIAN, Zhi-hong YANG, Rui RUAN, Qi-ying ZHANG, Ming-ting ZHOU, Xing-yin FANG. Application Value of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in Diagnosis of Space-occupying Lesions of Lung and Mediastinum[J]. Journal of Kunming Medical University, 2021, 42(3): 41-48. doi: 10.12259/j.issn.2095-610X.S20210311

Citation:

Lu YAO, Hui TAN, Yong-hua RUAN, Zhong-yi QIAN, Zhi-hong YANG, Rui RUAN, Qi-ying ZHANG, Ming-ting ZHOU, Xing-yin FANG. Application Value of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in Diagnosis of Space-occupying Lesions of Lung and Mediastinum[J]. Journal of Kunming Medical University, 2021, 42(3): 41-48. doi: 10.12259/j.issn.2095-610X.S20210311

Citation:

Lu YAO, Hui TAN, Yong-hua RUAN, Zhong-yi QIAN, Zhi-hong YANG, Rui RUAN, Qi-ying ZHANG, Ming-ting ZHOU, Xing-yin FANG. Application Value of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in Diagnosis of Space-occupying Lesions of Lung and Mediastinum[J]. Journal of Kunming Medical University, 2021, 42(3): 41-48. doi: 10.12259/j.issn.2095-610X.S20210311

PDF( 893 KB)

Application Value of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in Diagnosis of Space-occupying Lesions of Lung and Mediastinum

doi: 10.12259/j.issn.2095-610X.S20210311

1.
Dept. of Pathology
2.
Clinical Skills Center，Kunming Medical University，Kunming Yunnan 650500
3.
First Department of Thoracic Surgery，The Third Affiliated Hospital of Kunming Medical University & Yunnan Cancer Hospital，Kunming Yunnan 650118
4.
Dept. of Orthopedics，The First Affiliated Hospital，Kunming Medical University，Kunming Yunnan 650032
5.
Grade 2015 Clinical Medicine Major，Kunming Medical University，Kunming Yunnan 650500，China

Received Date: 2020-12-27
Publish Date: 2021-04-09

Abstract

Abstract

Objective To investigate the value of transbronchial needle aspiration biopsy （EBUS-TBNA） guided by ultrasound bronchoscope in the diagnosis of lung and mediastinal space-occupying lesions and staging of lung cancer. Methods Ninety patients with space-occupying lesions of lung and mediastinum underwent transbronchial needle aspiration biopsy guided by ultrasound bronchoscope. 151 specimens were embedded in paraffin, stained with HE, and diagnosed by cytopathology. Ki67 was detected by immunocytochemistry. Lymph node staging was performed for lung cancer. The coincidence rate and sensitivity of cytological diagnosis were analyzed according to the criteria of histopathological diagnosis combined with clinical diagnosis. Results The success rate of EBUS-TBNA puncture was 100% （151/151）, and the success rate of diagnosis was 91.1% （82/90）. The diagnostic rate of lung and mediastinal space-occupying lesions after EBUS-TBNA was significantly increased （P < 0.01）.Among 90 cases, malignant tumors accounted for 72.22% （65/90）, benign lesions accounted for 18.89% （17/90）, and 8.89% had no definite diagnosis （8/90）. 57 cases of malignant cells were found by cytology. The sensitivity of cytopathological diagnosis was 87.69%. TNM staging was achieved in 80% of lung cancers （44/55）. Ki67 positive index of pulmonary tuberculosis and granulomatous inflammation was 0-3%. The positive index of Ki67 in malignant pulmonary nodules ranged from 20% to 80%. There was significant difference in Ki67 expression between benign and malignant lung lesions （P < 0.01）. Conclusions EBUS-TBNA is a safe, sensitive and accurate diagnostic method, which can significantly improve the diagnostic success rate of lung and mediastinal space-occupying lesions. It has important guiding significance and clinical application value for the classification, staging, treatment and prognosis of lung cancer. Ki67 positive index is an important reference index for judging the benign and malignant of EBUS-TBNA puncture cells.
- EBUS-TBNA,
- Lung cancer,
- Lung nodule,
- Tuberculosis,
- Sarcoidosis,
- Cytology,
- Ki-67

FullText(HTML)

References(16)

References

[1]	Yasufuku K,Nakajima T,Fujiwara T,et al. Role of endobronchial ultrasound-guided transbronchial needle aspiration in the management of lung cancer[J]. Gen Thorac Cardiovasc Surg,2008,56(6):268-276. doi: 10.1007/s11748-008-0249-4
[2]	Detterbeck F C,Boffa D J,Kim A W,et al. The eighth edition lung cancer stage classification[J]. Chest,2017,151(1):193-231. doi: 10.1016/j.chest.2016.10.010
[3]	Westcott J L,Rao N,Colley D P. Transthoracic needle biopsy of small pulmonary nodules[J]. Radiology,1997,202(1):97-103. doi: 10.1148/radiology.202.1.8988197
[4]	Travis W D,Brambilla E,Nicholson A G,et al. The 2015 World Health Organization classification of lung tumors:impact of genetic,clinical and radiologic advances since the 2004 classification[J]. J Thora Oncol,2015,10(9):1243-1260. doi: 10.1097/JTO.0000000000000630
[5]	Righi L,Franzi F,Montarolo F,et al. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)-from morphology to molecular testing[J]. J Thora Dis,2017,9(5):395-404.
[6]	Kim J,Kang H J,Moon S H,et al. Endobronchial ultrasound-guided transbronchial needle aspiration for re-biopsy in previously treated lung cancer[J]. Cancer Res Treat,2019,51(4):1488-1499. doi: 10.4143/crt.2019.031
[7]	Muthu V,Sehgal I S,Dhooria S,et al. Endobronchial ultrasound-guided transbronchial needle aspiration:techniques and challenges[J]. J Cytol,2019,36(1):65-70. doi: 10.4103/JOC.JOC_171_18
[8]	韩非,张俭,孙加源,等. EBUS-TBNA细胞学检查对肺癌及结节病的诊断价值[J]. 上海交通大学学报(医学版),2011,31(12):1737-1740. doi: 10.3969/j.issn.1674-8115.2011.12.017
[9]	Shiina Y,Sakairi Y,Wada H,et al. Sclerosing pneumocytoma diagnosed by preoperative endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)[J]. Surg Case Rep,2018,4(1):20. doi: 10.1186/s40792-018-0429-0
[10]	李维华, 纪小龙. 呼吸系统病理学[M]. 北京: 人民军医出版社, 2011: 331-334.
[11]	Erol S,Anar C,Erer O F,et al. The Contribution of ultrasonographic characteristics of mediastinal lymph nodes on differential diagnosis of tuberculous lymphadenitis from sarcoidosis[J]. Tanaffos,2018,17(4):250-256.
[12]	Trisolini R,Baughman R P,Spagnolo P,et al. Endobronchial ultrasound-guided transbronchial needle aspiration in sarcoidosis:Beyond the diagnostic yield[J]. Respirology,2019,24(6):531-542. doi: 10.1111/resp.13537
[13]	Taguchi A,Arenberg D. Harnessing immune response to malignant lung nodules. Promise and challenges[J]. Am J Respir Crit Care Med,2019,199(10):1184-1186.
[14]	Gu Q,Feng Z,Liang Q,et al. Machine learning-based radiomics strategy for prediction of cell proliferation in non-small cell lung cancer[J]. Eur J Radiol,2019,118:32-37. doi: 10.1016/j.ejrad.2019.06.025
[15]	杨宁,金大成,陈猛,等. 人工智能在肺癌诊断中的研究进展[J]. 中国胸心血管外科临床杂志,2020,27(10):1-6.
[16]	Harris D,Saha S. Endobronchial ultrasound-guided biopsy for evaluation of suspected lung cancer[J]. Asian Cardiovasc Thora Ann,2019,27(6):471-475. doi: 10.1177/0218492319853184

Relative Articles(20)

Relative Articles

[1]	Ying WANG, Cong FU, Ying FU. Clinical Implications of Serum LDH，CysC，and PWR Level Detection in Lung Cancer Patients. Journal of Kunming Medical University, 2024, 45(4): 163-169. doi: 10.12259/j.issn.2095-610X.S20240424
[2]	Jiang ZHANG, Xijuan ZHAO, Jiang WU, Bingkun YANG, Ni YANG, Liping ZHOU. Analysis of Frailty Status and Influencing Factors in Lung Cancer Patients Undergoing Radiotherapy. Journal of Kunming Medical University, 2024, 45(9): 1-8.
[3]	Wangxun SHEN, Yinyu YANG, Canwei LI, Jinrong YANG, Sijing WU, Huajun ZHAO, Xiaoyu TUO. Expression and Clinical Significance of ROR1 in Different Histologic Types of Invasive Lung Adenocarcinoma. Journal of Kunming Medical University, 2024, 45(5): 60-65. doi: 10.12259/j.issn.2095-610X.S20240509
[4]	Lianyong CHEN, Xing YANG, Haohao RU, Tao CHEN, Shuangqun YAN, Lin XU. Analysis of Molecular Characteristics of Mycobacterium Tuberculosis and Factors Associated with Transmission in Yunnan Province. Journal of Kunming Medical University, 2023, 44(8): 1-7. doi: 10.12259/j.issn.2095-610X.S20230821
[5]	Xiaoyan WANG, Ya LI, Chenglu HE, Lin WANG, Zhiqiang MA, Xinrui WAN. Study on Immune Function and Drug Resistance of Tuberculosis Patients Co-infected with HBV，HCV and HIV in Yunnan. Journal of Kunming Medical University, 2023, 44(12): 51-58. doi: 10.12259/j.issn.2095-610X.S20231209
[6]	Lin WANG, Lingjun SHEN, Haiwen LI, Xiaoyan WANG, Jianpeng GAO, Zhiqiang MA. Analysis of Nutritional Status and Immune Function of Tuberculosis Patients in Yunnan. Journal of Kunming Medical University, 2023, 44(1): 109-115. doi: 10.12259/j.issn.2095-610X.S20230116
[7]	Yongchang LV, Wei LUO, Xugang ZHANG, Ran CAO, Ziqiang LI, Rong WANG, Qiying ZHENG, Yuekun LIU, Tingyan LIU, Jili YIN, Peipei DING, Kun WANG. Effect of Combined Intervention of Thoracic Surgery and Rehabilitation Department on Fast Track Surgery of Patients after Uniportal Video-assisted Thoracoscopic Surgery. Journal of Kunming Medical University, 2022, 43(10): 104-109. doi: 10.12259/j.issn.2095-610X.S20221013
[8]	Lin WANG, Yingrong DU, Jianpeng GAO, Mingwu LI, Lingjun SHEN, Zhiqiang MA. Nutritional Status of Elderly Tuberculosis Patients in Yunnan. Journal of Kunming Medical University, 2022, 43(4): 32-37. doi: 10.12259/j.issn.2095-610X.S20220432
[9]	Rong WAN, Guangmei LI, Meng MA, Minghong LAI, Cai LIU, Mingwu LI. Clinical Features of Tuberculosis with Negative T Cell Spot Test in Peripheral Blood. Journal of Kunming Medical University, 2022, 43(4): 132-136. doi: 10.12259/j.issn.2095-610X.S20220420
[10]	Fei SONG, Ying-ying XIANG, Ji-gui ZHANG, Jia- yin CHE, Lin LI, Ming HUANG. The Clinical Study of Bronchial Artery Infusion Chemotherapy via Radial Artery. Journal of Kunming Medical University, 2021, 42(9): 134-137. doi: 10.12259/j.issn.2095-610X.S20210921
[11]	Chen Lian Yong , Ru Hao Hao , Yang Xing , Yan Shuang Qun , Chen Jin Ou , Yang Rui , Chen Tao , Xu Lin . . Journal of Kunming Medical University, 2020, 41(03): 45-49.
[12]	Wang Hong . Role of Prostaglandin E2 in the Pathogenesis of COPD with Lung Cancer. Journal of Kunming Medical University,
[13]	Fan Ping . . Journal of Kunming Medical University,
[14]	Pan Long Fang . . Journal of Kunming Medical University,
[15]	Tian Yang . . Journal of Kunming Medical University,
[16]	Chen Jin Run . . Journal of Kunming Medical University,
[17]	Gao Xiao Jiao . . Journal of Kunming Medical University,
[18]	. The Clinical Value of T-SPOT.TB,TB-DNA,PPD and TB-DOT/TB-CK Test in the Diagnosis of Tuberculosis. Journal of Kunming Medical University,
[19]	. Clinical Application of Fiberoptic bronchoscopy Brush Cytology in Diagnosis of Lung Cancer. Journal of Kunming Medical University,
[20]	. Clinical Research of the Expression and Correlation of KI-67 and Survivin in Cervical Carcinoma. Journal of Kunming Medical University,