The Application Of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration In The Diagnosis Of Mediastinal Pulmonary Disease

Objective: We retrospectively analyzed the the clinical data of 106 patients who underwent endoscopic ultrasonography and bronchoscopic needle biopsy(EBUS-TBNA)in our hospital.Evaluate the diagnostic value of EBUS-TBNA in mediastinal hilar lymph nodes or lumps,and improve the clinical doctor's understanding of this technique,so as to provide a more optimized examination method for the diagnosis and treatment options of patients.Methods: In our hospital from June 2016 and December 2017,we found 106 patients with mediastinal hilar lymph nodes or lumps by imaging and EBUS-TBNA examination and pathological examination reported in our hospital.The sensitivity,specificity,accuracy,negative and positive predictive value of EBUS-TBNA in the diagnosis of benign and malignant diseases such as tuberculosis and lung cancer were analyzed.The cytological,histological and immunohistochemical methods in the diagnosis of malignant diseases Influence,analyze the positive rate of disease diagnosis and the number of lymph nodes / tumor puncture needle,the number of puncturing lymph nodes.Results:(1)The sensitivity,specificity,accuracy,positive and negative predictive value of EBUS-TBNA for the diagnosis of lung cancer and malignant disease were 90.74%,100%,95.28%,100%,91.23%,90.16%,100%,94.34% 100%,88.23%;(2)The sensitivity,specificity,accuracy,positive and negative predictive value of EBUS-TBNA for tuberculosis and benign diseases were 72.22%,100%,90.56%,100%,87.5%,71.11%,100%,87.73%,100%,82.43%;(3)Increased number of puncture needles and number of puncture lymph nodes can increase the positive rate of EBUS-TBN A in the diagnosis of disease,but the statistical difference is not significant(P>0.05);(4)Histomorphometry combined with immunohistochemistry can improve the diagnostic positive rate of lung cancer,but only in lung adenocarcinoma higher than simple cytology or histological differences were statistically significant(P<0.05).Conclusion:(1)EBUS-TBNA is an efficient,economical and convenient diagnostic method for mediastinal hilar lymph nodes / lump disease.(2)The diagnostic value of EBUS-TBNA for lung cancer and malignant diseases is higher than the diagnostic value of tuberculosis and benign diseases.(3)Increasing the number of puncturing or lymph node puncturing can improve the positive rate of disease diagnosis,but the difference is not statistically significant.(4)Histopathology combined with immunohistochemistry can improve the diagnostic positive rate of EBUS-TBNA puncture specimens,and EBUS-TBNA can also provide enough puncture specimens for EGFR detection.