以内支气管超声波为指导的中支气管淋巴结冷活检:对方法和结果的全面审查
Shiwani Kamath1, Abdullah Jahangir1, Salim Daouk1
1Interventional Pulmonary Program, Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Oklahoma Health Sciences Center and The Oklahoma City VA Health Care System, Oklahoma City, OK, USA.
Mediastinum (Hong Kong, China)
|April 14, 2025
概括
管内超声引导的横支气管冷活检 (EBUS-TBC) 显著改善了肺癌诊断产量,当添加到EBUS引导的横支气管针吸收 (EBUS-TBNA) 时. 这种新技术提供了更大的标本,有助于分子测试,并提高了各种肺部疾病的准确性.
科学领域:
- 肺部病理学 肺部病理学
- 干预性肺病学 干预性肺病学
- 瘤学 诊断 诊断 瘤学
背景情况:
- 胸腔内膜超声导向的跨胸腔针吸收 (EBUS-TBNA) 是肺癌诊断和分期的标准.
- 由于EBUS-TBNA的局限性,需要探索替代或补充技术.
- 内支支气管超声波引导的横支气管冷活检 (EBUS-TBC) 是一种新兴的方法,具有潜在的益处.
研究的目的:
- 审查和综合有关EBUS-TBC的现有文献.
- 为了比较EBUS-TBC与EBUS-TBNA的诊断产量和技术.
- 为优化EBUS-TBC的最大诊断产量提供见解.
主要方法:
- 我们对PubMed进行了系统的文献搜索,直到2024年5月.
- PICO框架指导了诊断产量,技术和并发症的评估.
- 分析了涉及857名患者的11项研究,重点关注EBUS-TBC,该研究是在EBUS-TBNA之后进行的.
主要成果:
- 对于EBUS-TBC的整体诊断收益率为91.9%,而单独用于EBUS-TBNA的收益率为76.6%.
- 与EBUS-TBNA相比,EBUS-TBC始终产生了比EBUS-TBNA更大的活检标本.
- 轻度出血是最常见的并发症,不显著增加不良事件.
结论:
- 将EBUS-TBC添加到EBUS-TBNA中可以提高肺癌和其他疾病的诊断产量.
- 来自EBUS-TBC的大型组织样本有利于下一代测序和提高诊断准确度.
- EBUS-TBC为EBUS-TBNA提供了有价值的补充,可以提高诊断能力,而不会增加重大风险.
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