Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of thoracic sarcoidosis

目的 探讨支气管内超声引导针吸活检术(endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)诊断胸部结节病的价值.方法 回顾性分析2009年9月至2011年6月接受EBUS-TBNA检查的35例临床拟诊胸部结节病患者的临床资料,所有患者术前胸部CT检查均发现肺门和(或)纵隔淋巴结肿大(≥1.O cm).对于EBUS-TBNA未能明确诊断的患者,进一步接受外科手术活检或至少6个月以上的临床及影像学随访.结果 35例患者,经EBUS-TBNA活检87组淋巴结,其中纵隔淋巴结64组,肺门及叶间淋巴结23组.最终明确诊断胸部结节病28例(80％),其中经EBUS-TBNA明确诊断25例(89.3％).所有患者检查耐受良好,无任何相关并发症发生.结论 EBUS-TBNA 是一种安全有效的诊断方法,对于Ⅰ、Ⅱ期胸部结节病有较高的诊断率.Objective To evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of thoracic sarcoidosis.Methods The study was retrospective,from September 2009 to June 2011,35 patients with suspected sarcoidosis,with enlarged hilar or mediastinal lymph nodes on computed tomography ( ≥1.0 cm),underwent EBUS-TBNA.Patients in whom EBUS-TBNA was nondiagnostic subsequently underwent surgical biopsy or a minimum of 6 months clinical and radiologic follow-up.Results EBUS-TBNA was performed on a total of 87 lymph node stations in 35 patients.Of the enlarged lymph nodes,64 (73.6％) were located in the mediastinal region and the remaining 23 ( 26.4％ ) around the hilar or interlobar area.A final diagnosis of sarcoidosis was made for 28 (80％) of the patients.In patients with a final diagnosis of sarcoidosis,EBUS-TBNA demonstrated noncaseating epithelioid cell granulomas in 25 ( 89.3％ ) of the patients.EBUS was well tolerated by all of the patients with no complications.Conclusion EBUS-TBNA is a safe procedure with a high yield for the diagnoses of thoracic sarcoidosis of stage Ⅰ or Ⅱ.首都医学发展科研基金中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)09529-531,5382