Diagnostic Value Of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration In Enlarged Mediastinal Lymph Nodes

Objective:The diagnostic value and safety of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)in enlarged mediastinal lymph nodes.Menthod:Thirty-seven patients with enlarged mediastinal lymph nodes by EBUS-TBNA in yijishan Hospital of Wan Nan Medical College from May 2018 to January 2020 were collected into our retrospective research.The final diagnosis was determined according to the histopathological results and follow-up for 3-6 months.The diagnosis results of benign and malignant diseases were recorded.The positive rate of pulmonary disease diagnosis in benign and malignant diseases was calculated by the histopathological examination obtained by EBUS-TBNA.To evaluate the value and safety of EBUS-TBNA in the diagnosis of enlarged mediastinal lymph nodes compare with the final clinical diagnosis.Results:1.22 of 37 cases were punctured postive,15 cases were lung tumour,including 12 cases of primary lung cancer,1 cases of lymphoma,2 cases of metastatic lung cancer;7 cases of benign diseases,including 2 cases of tuberculosis,2 cases of thoracic sarcoidosis,3 cases of nonspecific infiammation.15 cases were negative,of which 2 cases were confirmed as lung tumour by general fiberoptic bronchoscope,1 case was confirmed as pulmonary tuberculosis by sputum acid fast bacilli smear(+),1 case was confirmed as thoracic sarcoidosis by general fiberoptic bronchoscope,1 case was terminated due to intolerance,and the other 10 cases were not confirmed.compared with the final clinical diagnosis,the positive rate of EBUS-TBNA was 88.2%(15/17)for lung tumour and 77.8%(7/9)for benign diseases.2.A total of 48 qualified lymph nodes were punctured in 37 patients,Among them,7 groups of lymph nodes were punctured most,accounting for 68.8%(33/48)of the total number of specimens.There were 40 punctures in central group(4R,7group)and 8 punctures in peripheral group(10R,11 R,11L).3.36 of the 37 patients successfully completed EBUS-TBNA examination without serious complications,Only one patient was unable to tolerate the final stop operation.The main intraoperative complications of were irritant cough,small amount of bleeding at puncture point,transient arrhythmia and decrease of oxygen saturation.The main postoperative complications were damage of nasal mucosa,cough,blood in sputum and hoarseness.No serious complications were found.Conclusion:1.In this study,EBUS-TBNA as a new examination method,has a high diagnosis rate of 88.2% for lung tumour,93.3% for lung cancer,50% for lymphoma.77.8% for benign diseases,66.7% for tuberculosis,and 66.7% for thoracic sarcoidosis,with less adverse reactions and less trauma.It is a safe and effective endoscopy technology;2.In this study,the value of EBUS-TBNA in the diagnosis of lung cancer and other lung tumour is higher than that of tuberculosis and thoracic sarcoidosis.