Retrospective Study Of TBNA In High Risk Group Of Cancer With Mediastinal Lymph Nodes And Mediastinal Tumor

Mediastinum in the chest center-left,it is an anatomy area in between two chest. There are Heart, the heart of the great vessels, esophagus, trachea, thymus, nerve and lymph tissue, etc. Therefore, it is the location of vital organs. The hilar in the central of inside of lungs,It is the main bronchus, pulmonary artery, pulmonary veins, bronchial arteries and veins, lymphatic vessels, nerves and so out of place. Many reasons can cause swelling of Mediastinal and hilar lymph nodes. Common causes: lymph node metastasis, lymphoma, sarcoidosis, lymph node tuberculosis, non-specific reactive lymphoid follicular hyperplasia. If the cancer occurred here indicate poor prognosis, so attention to the reasons for swollen lymph nodes.Timely treatment, diagnosis, in order to avoid misdiagnosis, it is very important. Commonly used diagnostic methods: TBNA, thoracoscopy, thoracotomy. The TBNA is a minimally invasive, inexpensive method,And in recent years there have been many derivative technologies,Such as EBUS-TBNA,These techniques improve the detection rate, it became the focus of attention. The status of TBNA depends mainly on Ko Pen Wang's results in the technology to develop.Many studies have confirmed the value of the technology. TBNA can be a lot of lymph node biopsy, and fewer complications. This is very important for patients with benign and malignant and staging of lung. Although EBUS-TBNA can increase the positive rate of TBNA.However, the real situation, due to EBUS-TBNA complicated operation, expensive, high cost of technical training, it is hardly a means of Malignant hilar and mediastinal diseases screening.Therefore, we need to diagnose the disease by TBNA] [However, the traditional TBNA worse than the EBUS-TBNA.Therefore, we need to sum up the common characteristics in high risk of cancer.In conjunction with other methods.To reduce the rate of missed diagnosis of malignancy,to enhance cancer screening efforts, clinicians in the diagnosis and treatment process to provide a reference.Abstract Objective To evaluate the preliminary screening value of TBNA (transbronchial needle aspiration ) in the diagnosis of patients with mediastinal mass and enlarged lymph nodes. To retrospective anlyze the gender,age, location of enlarged lymph nodes and pathologic diagnosis in these patients. and to propose the data of TBNA in high risk group with enlarged simplex mediastinal lymph nodes. Methods Collected the clinical data of patients with enlarged simplex mediastinal lymph node,who were examined with TBNA, from Jun,2003 to Jun.2009. And compared the diagnosis methods of single TBNA with synthetical methods in patients with diagnosed malignant tumor. And statistical analyze the data of gender, age, location of enlarged lymph nodes and pathologic diagnosis. Results There is no significant difference in first time TBNA with synthetical methods for dignosis rate of malignant tumors(P>0.05); There is significant difference in constituent ratio of malignancy and benign lesion in related to gender, age ,location of enlarged lymph nodes and pathologic diagnosis (P<0.01). And the ratio of malignancy tumor is higher in males and in older(P<0.05). There is statisticd significance in the difference of related rate of malignancy and benign lesion in different puncture of site(P<0.01). Malignant lesion was detected more frenqently than benign lesion in pulmonary hilar and subcarinal enlarged lymph nodes(P<0.01). The detected rate is significatn difference for different pathological subtypes of malignant lesion in subcarinal and pulmonary hilar lymph node(P<0.01). The detected rate of small cell lung cancer is higher in subcarinal lymph nodes than in pulmonary hilar lymph node, but on the contrary, the detected rate of nonsmall-cell lung cancer is higher in pulmonary hilar lymph nodes(P<0.01). Conclusion 1.The TBNA is a major diagnostic tool in simple mediastinal hilar lymphadenopathy disease. In such diseases, the TBNA as a Cancer screening methods to get attention.2.In patients of Malignant hilar and mediastinal lymph nodes, Men significantly more than females. Help for men at high risk cancer and gender composition ratio is burden of disease of cancer.3. In patients of Malignant hilar and mediastinal lymph nodes, Age of onset of malignant than benign. Help elderly patients at high risk of Malignant mediastinal and hilar lymphadenopathy disease. Age is burden of disease of cancer.4. The detected rate of small cell lung cancer is higher in subcarinal lymph nodes than in pulmonary hilar lymph node, but on the contrary, the detected rate of adenocarcinoma is higher in pulmonary hilar lymph nodes(P<0.01). Description Subcarinal lymph nodes is the common site of small cell carcinoma and Hilar lymph node is the common site of adenocarcinoma.5. Have false negative results in the TBNA.Therefore, these "benign results" need to rely on "follow up" to rule out malignancy. In this period, To observe the efficacy of experimental anti-tuberculosis treatment and experimental hormone treatment play an important role in helping to disease diagnosis.