. MD, MSc-

( , pack/years )

-

27% , 34% (, , ), 32%

%8-75 0-683-60 20-496-35 6-250-200-200-10 0-40-2 (-)0-2

10% , , , Cushing (30-50%, SCLC) (, ) (1-5%, SCLC) (3%, NSCLC) (LEMS, SCLC)

( 60%, 81%)PET/CT scan ( 84%, 89%)

(R-EBUS) (Electromagnetic Navigation). (-TTNB)

: .

: ( 3, 68% 1 , 78% 2 85-86% 3 > ) ( 71% , 49% ) (>2,4 cm)

, B .

(74%) (59%) (48%)/ ( ) 88%

( 57%) ( 54%) ( 43%)

78%

.

2cm: 34% >2cm: 63%

Radial EBUS

R-EBUS transducer , 360 20 MHz (12 &30 MHz) 4-5 cm 1 mm 2 &2,8 mm 50-75

R-EBUS

73% 100% 2cm: 56% >2cm: 78%

Real Time EBUS-TBNA transducer , . - 93% 100%.

Angle of view: 90Direction of view: 30 forward oblique

( , CT, CT ). CT, GPS, .

74% .

CT 90% 1-2% 20-30% .

15865 1% (18% ) 15% (7% )

60-69

(, , )

- ( 0% TUS, 29% TUS) 72% 2 , (65% 1, 27% 2, 5% 3 ) 50 ml : ()TUS 79% ( >1, , >7)

, :

(Abrams 57%) ( 84%, NPV 75-80%, 5%) ( 80-99%, 93-100%, NPV 93-96%)124 , , - , , CT-ANPB medical thoracoscopy, 88% 93% 94% 100% .

CT-ANPB . CT .

(K-ras, EGFR, EML4-ALK, c-ros oncogene 1(ROS) )

DNA (circulating tumor DNA, ctDNA) ( EGFR NSCLC). EGFR (gefitinib).

,