The Comparison Of Diagnositic Value Between EBUS-TBNA And CTBNA In Stageâ… and Stageâ…¡ Of Sarcoidosis

Objective: To evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA) in stageⅠ and stageⅡ of sarcoidosis.compared the diagnostic yield of endobronchial ultrasound guided transbronchial needle aspiration(EBUS-TBNA) and conventional transbronchial needle aspiration(c TBNA) in the diagnosis of sarcoidosis to assess their diagnositic value.Methods: There were 55 patients of sarcoidosis selected from January 2012 to October 2014 in the First Affiliated Hospital of Soochow University. To calculate the diagnosis positive rate and the positive rate in stage I and II patients with sarcoidosis through EBUS-TBNA, c TBNA, endobronchial biopsy(EBB) combined with transbronchial lung biopsy(TBLB). The positive rate of single lymph node puncture and the positive rate of different size of lymph node were compared. To observe the difference of the positive rate of lymph nodes in different stations. By comparing the diagnostic accuracy of sarcoidosis among the EBUS-TBNA and c TBNA, to evaluate the practicality and safety of EBUS-TBNA and c TBNA in diagnosis and treatment in patients with stageⅠor stage Ⅱ sarcoidosis.Results: Among 55 patients, 46 patients obtained positive results through EBUS-TBNA or c TBNA. There were 18 patients who had only received EBUS-TBNA among a total of 55 patients diagnosed with sarcoidosis, positive results appeared in 17cases(94.4%), while c TBNA was 60%(9/15). There were 22 cases had both EBUS-TBNA and c TBNA, 20 patients were diagnosed. The diagnostic rate of c TBNA combine with EBB and TBLB was 96.1%(25/26), While EBUS-TBNA was 100%(21/21). Totally 90 lymph nodes were punctured by EBUS-TBNA, in which 65 lymph nodes got the positive results(65 /90) while 49 lymph nodes got the positive results by TBNA in 93 puncturedlymph nodes(49/93). The diagnostic positive rate in the Lymph nodes with a short diameter ≥2 cm was 89%(33/37) by EBUS-TBNA, while it was 63%(12/19) in those one whose short diameter<2cm. In c TBNA the diagnostic positive rate was 57%(15/26) and39%(11/28). No serious adverse events occurred during EBUS-TBNA and c TBNA.Conclusions:1.As a single biopsy technique,EBUS-TBNA has a higher diagnostic positive rate than c TBNA(P=0.033).2.Choosing the most noticeable swelling lymph node to puncture could have a satisfying diagnostic positive rate.Combining EBUS-TBNA with traditional bronchoscope technology can obtain a higher diagnostic efficiency.3.There are no statistical difference between EBUS-TBNA+EBB+TBLB and c TBNA+EBB+TBLB.4.Both EBUS-TBNA and c TBNA are safe and effective method for biopsy.