标题：超声支气管镜引导下支气管肺癌穿刺活检假阴性的影响因素

      作者：肖中 1，周晨 1，姚小鹏 2    1.上海中医药大学附属第七人民医院呼吸内科，上海 200137；2.海军军医大学附属长海医院呼吸与危重症医学科，上海 200433

      卷次： 2019年30卷22期

      【摘要】 目的 分析肺癌病灶在超声支气管镜引导下经支气管针吸活检(EBUS-TBNA)穿刺病理结果阴性的影响因素。方法 回顾性研究2017年1月至2018年2月在上海中医药大学附属第七人民医院行EBUS-TBNA术的25例最终经EBUS-TBNA或其他活检方法病理证实为肺癌患者的临床资料，分别记录病理类型、穿刺病灶的大小和穿刺获取标本的性状，采用卡方检验分析影响EBUS-TBNA假阴性的相关因素。结果 25例肺癌患者共穿刺57处病灶，病理类型中小细胞肺癌为57.9% (11/19)，明显高于非小细胞肺癌的21.1% (8/38)，差异具有统计学意义(P<0.05)；穿刺物呈碎渣样改变者为 80.0% (12/15)，明显高于线样长条改变者的 9.5% (4/42)，差异具有统计学意义(P<0.05)；小细胞肺癌病灶直径>3 cm者为75.0% (9/12)，明显高于直径<3 cm者的28.5% (2/7)，差异具有统计学意义(P<0.05)；穿刺病灶直径>3 cm的小细胞肺癌出现碎渣样改变者58.3% (7/12)，明显高于非小细胞肺癌16.7% (2/12)，差异具有统计学意义(P<0.05)。结论 穿刺物为碎渣样改变者出现假阴性比例高；小细胞肺癌且肿块直径>3 cm，穿刺标本为碎渣样改变，是导致EBUS-TBNA出现假阴性的关键因素。
      【关键词】 肺癌；超声引导下穿刺活检术；假阴性；线样长条；碎渣样
      【中图分类号】 R734.2 【文献标识码】 A 【文章编号】 1003—6350（2019）22—2969—03

Factors related to false-negative results in ultrasound-guided transbronchial needle aspiration in lung cancer.XIAO Zhong 1, ZHOU Chen 1, YAO Xiao-peng 2.
1.Shanghai Seventh People's Hospital Affiliated to Shanghai University ofTraditional Chinese Medicine, Shanghai 200137, CHINA; 2. Department of Respiration and Critical Care Medicine,Changhai Hospital Affiliated to the Second Military Medical University, Shanghai 200433, CHINA
【Abstract】 Objective To discuss the factors related to false-negative results in ultrasound-guided transbron-chial needle aspiration in lung cancer. Methods The clinical data of 25 patients finally diagnosed as lung cancer byEBUS-TBNA or other biopsy methods in Shanghai Seventh People's Hospital Affiliated to Shanghai University of Tra-ditional Chinese Medicine were retrospectively reviewed. The pathological types, the size of puncture lesions, and thecharacteristics of puncture specimens were recorded respectively. Results A total of 57 lesions were punctured in the25 patients with lung cancer. The proportion of small cell lung cancer was 57.9% (11/19), significantly higher than21.1% (8/38) of non-small cell lung cancer (P<0.05). The rate of samples in the form of dregs was significantly higherthan that of samples in the shape of linear strip: 80.0% (12/15) vs 9.5% (4/42), P<0.05. The proportion of lesions big-ger than 3 cm in small cell lung cancer was significantly higher than that of lesions smaller than 3 cm in small celllung cancer 75.0% (9/12) vs 28.5% (2/7), P<0.05. The proportion of dregs sample in small cell lung cancer with the le-sions bigger than 3 cm was 58.3% (7/12), significantly higher than 16.7% (2/12) in non-small cell lung cancer (P<0.05). Conclusion Higher false-negative rate was found in samples in the form of dregs. Small cell lung cancer with amass diameter of more than 3 cm and samples in the form of dregs were the key factors leading to false negative inEBUS-TBNA.
      【Key words】 Lung cancer; Ultrasound-guided transbronchial needle aspiration; False negative results; Linearstrip; Dregs·短篇论著·doi:10.3969/j.issn.1003-6350.2019.22.034