| Objective:Endobronchial ultrasound,with a ultrasound probe in the front of bronchoscopes,combines bronchoscopy with ultrasound,which can enhance the definition of mediastinal structures and reduce the biopsy sampling errors effectively.Endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)rapidly became an effective and minimally invasive technique for cheset diseases in the last two decades.This study aimed to evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in chest diseases by a retrospective analysis of large sample.Methods:Retrospective analyzes all of the patients who aimedto undergo EBUS-TBNA in our department from 2009-5-20 to 2015-6-30,a total numbr of 1022,by recording their clinical data,microbiology,histopathology or clinical data followed-up.SPSS was used to analyze the data.Results:(1)1022 cases that underwent endobronchial ultrasound examination were analyzed in this study,977 underwent transbronchial needle aspiration,a rate of 95.6%.7 and 4 lymph nodes were punctured most frequently.911 were diagnosed definitely by the examination,a rate of 89.14%.The reasons of the cases who failed to underwent transbronchial needle aspiration were rich blood supply(9/1022),vascular barrier(8/1022),difficult to locate(7/1022),cystic diseases(6/1022),no lesions under ultrasound probe(4/1022),tracheal cartilage barrier(3/1022),little lesions difficult to puncture(3/1022),patients can't to cooperate for cough(3/1022),endobronchial lesions(2/1022),thrombus lesion under ultrasound probe(1/1022).There were no sivere complications related to EBUS-TBNA.All the cases were divided into two groups by the results of histopathology aiming to investigate the likely influential factors,one group with definitely diagnosis and the other group with unclear diagnosis.The factors to be investigated include the age of patients,the lymph nodes whith were punctured,the number of biopsy samples,the number of the lymph nodes which were punctured and the number of EBUS-TBNA cases of the operators.Logistic regression analysis was used to statistic.Multivariate Logistic regression analysis identified two influential factor were the number of biopsy samples(P=0.031)and the number of EBUS-TBNA cases of the operators(P=0.025).(2)There were 502 cases diagnosed definitely with malignant diseases after EBUS-TBNA,the sensibility was 95.62%,the specificity was 100%,the positive predictive value was 100%,the negative predictive value was 25.81%.(3)There were 334 cases diagnosed definitely with benign diseases after EBUS-TBNA,the sensibility was 89.30%,the specificity was 100%,the positive predictive value was 100%,the negative predictive value was 16.67%.Result:EBUS-TBNA is an effective and minimally invasive technique,which plays a pivotal role in diagnose of chest diseases. |
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