虚拟支气管镜导航联合支气管超声导向鞘引导肺活检术在肺周围性病变诊断中的应用被引量：20

Diagnostic Utility of Virtual Bronchoscopic Navigation Assisted Endobronchial Ultrasonography with Guide Sheath for Peripheral Pulmonary Lesions

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摘要背景与目的虚拟支气管镜导航(virtual bronchoscopic navigation, VBN)联合支气管超声导向鞘技术(endobronchial ultrasonography with guide sheath, EBUS-GS)用于经支气管肺活检术(transbronchus lung biopsy,TBLB),能够减少甚至避免射线暴露。本研究拟评价VBN联合EBUS-GS对肺周围性病变(pulmonaryperipheral lesions,PPLs)的诊断价值及安全性。方法回顾性分析2016年1月-2017年12月在北京大学肿瘤医院内镜中心接受EBUS-GS-TBLB患者的临床病理资料,评价诊断率及安全性,并对影响诊断率的因素进行分析。结果 121例患者纳入本研究,男性65例,女性56例;平均年龄(58.8±10.3)岁。108例(89.3%)可在EBUS图像中显示,共有89例(73.5%)经EBUS-GS-TBLB获得明确诊断。EBUS-GS-TBLB对恶性病变的诊断率为82.5%。联合刷检、活检及肺泡灌洗中两种或三种方式取检的诊断率(87.2%)高于仅采用单一方式取检(58.8%)(χ~2=6.084, P=0.014)。影响EBUSGS-TBLB诊断率的因素包括超声探头位于病灶内部(χ~2=20.372,P=0.000)、病灶位于肺野内带及中带(χ~2=10.810,P=0.001)。1例(0.8%)患者术中出血量较多。结论 VBN联合EBUS-GS-TBLB是一种诊断PPLs安全且有效的方法。 Background and objective Virtual bronchoscopic navigation(VBN) assisted endobronchial ultrasonography with guide sheath(EBUS-GS) has reduced the difficulty and even avoiding radiation exposure during performing transbronchus lung biopsy(TBLB). To evaluate the feasibility and safety of virtual bronchoscopic navigation assisted endobronchial ultrasonography with guide sheath for peripheral pulmonary lesions. Methods We performed a retrospective analysis of the patients with PPLs who received VBN assisted EBUS-GS-TBLB in Peking University Cancer Hospital from January 2016 to December 2017. Their clinicopathologic data and complications were assessed. Results A total of 121 patients were enrolled in the study. The patients included 65 men and 56 women, with a mean age of(58.8±10.3) years. A total of 121 PPLs were examined, and 108 lesions of which could be detected by EBUS. The overall diagnostic yield of EBUS-GS was 73.5%. The diagnostic yield of malignancy was 82.5%. The combination of transbronchial lung biopsy, brush smear and bronchoalveolar lavage fluid provided the greatest diagnostic yield(χ^2=6.084, P=0.014). Factors that significantly affected and predicted diagnostic success were EBUS probe within the lesions(χ^2=20.372, P=0.000) and PPLs located in the central two-thirds of the lung(χ^2=10.810, P=0.001). 1 patient(0.8%) suffered from intraoperative bleeding which could be managed under endoscopy. Conclusion VBN assisted EBUS-GS-TBLB for PPLs was an effective and safe procedure.

作者李士杰闫万璞陈麦林孙利吴齐陈克能 Shijie LI;Wanpu YAN;Mailin CHEN;Li SUN;Qi WU;Keneng CHEN(Department of Endoscopy Center, Peking University Cancer Hospital and Institute, Beijing 100142, China;The First Department of Thoracic Surgery,Peking University Cancer Hospital and Institute, Beijing 100142, China;Department of Radiology,Peking University Cancer Hospital and Institute, Beijing 100142, China;Department of Pathology,Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China)

机构地区北京大学肿瘤医院暨北京市肿瘤防治研究所北京大学肿瘤医院暨北京市肿瘤防治研究所北京大学肿瘤医院暨北京市肿瘤防治研究所北京大学肿瘤医院暨北京市肿瘤防治研究所

出处《中国肺癌杂志》 CAS CSCD 北大核心 2019年第3期125-131,共7页 Chinese Journal of Lung Cancer

基金北京市属医院科研培育计划项目(No.PX2016057)资助~~

关键词肺周围性病变支气管超声导向鞘虚拟支气管镜导航 Pulmonary peripheral lesions Endobronchial ultrasonography with guide sheath Virtual bronchoscopy

分类号 R734.2 [医药卫生—肿瘤]

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