Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration combined with ;Surepath liquid-based cytology test for lung lesions and mediastinal lymphadenopathy
10.3760/cma.j.issn.0529-5807.2015.09.005
- VernacularTitle:支气管超声内镜引导下针吸活检结合液基细胞学检查对肺及纵隔淋巴结病变的诊断价值
- Author:
Shenghua XIONG
1
;
Nian LIU
;
Qingbing HAN
;
Yong JIANG
;
Xueying SU
Author Information
1. 四川大学华西医院病理科
- Keywords:
Lung neoplasms;
Mediastinal diseases;
Biopsy,needle;
Lymph nodes;
Cytodiagnosis
- From:
Chinese Journal of Pathology
2015;(9):633-638
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration ( EBUS-TBNA) combined with Surepath liquid-based cytology test for lung and mediastinal lymphadenopathy.Methods Eighty EBUS-TBNA cases in West China Hospital of Sichuan University collected from December 2011 to June 2014 were retrospectively analyzed.The conventional smears and Surepath liquid based preparations were reviewed and compared with histological biopsy.Evaluated whether liquid based preparation could improve the satisfactory rate and diagnostic accuracy.Results This study included 53 men and 27 women, the male to female ratio was 1.96∶1.00; the age ranged from 17 to 79 ( mean 54) years.One to four lymph node groups were aspirated in each patient, resulting in a total of 109 lymph node groups, including 57 paratracheal, 34 subcarinal, three tracheal bronchial, seven pulmonary and four hilar lymph node groups.The definite locations of four other mediastinal lymph node groups were not known.The overall satisfactory rate of conventional smears and liquid-based cytology test was 90.0% and 92.5%, respectively.By histology, there were 37 cases diagnosed as malignant tumors, nine as tuberculosis, two as sarcoidosis, 11 as unexplained granulomatous inflammation, and 27 as other benign lesions.The sensitivity, specificity and accuracy of conventional cytological smears for tumors were 86.5%, 97.7% and 92.5% respectively; the positive and negative predictive values were 97.0% and 89.4% respectively.The sensitivity, specificity and accuracy of the liquid-based preparation were 89.2%, 97.7%and 93.8%respectively;the positive and negative predictive values were 97.1% and 91.3% respectively.Combining the conventional cytological smears and liquid based preparation, the sensitivity, specificity and accuracy were 91.9%, 97.7%and 95.0%respectively;and the positive and negative predictive values were 97.1% and 93.3% respectively.Conclusions EBUS-TBNA is a good method to diagnose lung and mediastinal lymphadenopathy.Surepath liquid based cytology test could improve the sample satisfactory rate, the diagnostic sensitivity and accuracy.If combined with immunocytochemistry it could be useful for further tumor typing.EBUS-TBNA combined with Surepath liquid based preparation is an effective complement for the histologic biopsy.
