气道径向超声引导多维度联合检查对周围型肺癌的诊断价值

doi:10.3969/j.issn.1000-8535.2023.03.007

摘要/Abstract

摘要： 目的探讨气道径向超声(RP-EBUS)引导多维度联合检查对周围型肺癌的诊断价值。方法选取2019年9月—2021年12月于佛山市第二人民医院确诊的74例周围型肺癌患者,分析RP-EBUS引导肺活检、支气管黏膜刷检、支气管肺泡灌洗细胞学及DNA甲基化检测等多维度联合检查对周围型肺癌的诊断阳性率及影响因素。结果 RP-EBUS引导肺活检、支气管黏膜刷检、支气管肺泡灌洗液细胞学、DNA甲基化检测对周围型肺癌的诊断阳性率分别为52.7%、47.3%、45.9%和51.4%,RP-EBUS引导多维度联合检查阳性率为71.6%,高于单一方法检查(P<0.05);RP-EBUS引导多维度联合检查病灶直径≥30 mm诊断阳性率高于病灶直径＜30 mm (82.9% vs 57.6%),差异有统计学意义(P<0.05);RP-EBUS引导多维度联合检查在肺上叶、中叶/舌叶、下叶病灶的阳性率分别为69.7%、66.7%和76.9%,差异无统计学意义(P>0.05);联合检查中超声探及病灶的诊断阳性率高于超声未探及病灶(76.9% vs 33.3%),差异有统计学意义(P<0.05);病灶超声图像表现为中心均实型的联合检查诊断阳性率高于非中心均实型(86.0% vs 59.1%),差异有统计学意义(P<0.05)。结论 RP-EBUS引导多维度联合检查对周围型肺癌有更高的诊断阳性率,诊断阳性率与病灶大小、超声是否探及病灶及病灶超声图像特征有关,与病灶部位无关。

关键词: 气道径向超声, 多维度联合检查, 周围型肺癌, 诊断价值

Abstract: Objective To investigate the value of radial probe endobronchial ultrasound (RP-EBUS)guided multi-dimensional combined examination in the diagnosis of peripheral lung cancer. Methods A retrospective analysis of 74 patients with peripheral lung cancer which were diagnosed in Foshan Second People's Hospital from September 2019 to December 2021 was carried out. RP-EBUS guided biopsy, brushing biopsy, bronchus alveolar lavage cytology and DNA methylation detection results were analyzed to obtain the positive diagnosis rate and influencing factors. Results The positive rates of RP-EBUS guided biopsy, brushing biopsy, bronchus alveolar lavage cytology and methylation for peripheral lung cancer were 52.7%, 47.3%, 45.9% and 51.4%, respectively. The positive rate of RP-EBUS guided multi-dimensional combined detection was 71.6%, which was significantly higher than single detection (P<0.05). The positive rate of RP-EBUS multi-dimensional combined examination in lesions diameter ≥30 mm was higher than that of lesion diameter ＜30 mm (82.9% vs 57.6%, P<0.05). The positive rate of RP-EBUS guided multi-dimensional combined group in the upper lobe, middle lobe/lingual lobe, and lower lobe of the lung were 69.7%, 66.7% and 76.9%, respectively, with no significant difference (P>0.05). The positive rate of ultrasound detected lesion in combined group was higher than that of undetected lesions (76.9% vs 33.3%, P<0.05). The ultrasound images of solid center lesions had higher positive rates than that of non solid center lesions (86.0% vs 59.1%, P<0.05). Conclusions RP-EBUS guided multi-dimensional combined examination has a higher positive rate for diagnosis of peripheral lung cancer. The positive rate of diagnosis are related to the size of the lesion, whether the lesion is detected by ultrasound and the characteristics of the ultrasound image of the lesion, but not related to the location of the lesion.

Key words: radial probe endobronchial ultrasound, multi-dimensional combined examination, peripheral lung cancer, diagnostic value

陈绍森, 胡佩村, 陈露, 黄琨伦. 气道径向超声引导多维度联合检查对周围型肺癌的诊断价值[J]. 广州医药, 2023, 54(3): 35-40.

CHEN Shaosen, HU Peicun, CHEN Lu, HUANG Kunlun. Value of radial probe endobronchial ultrasound guided multi-dimensional combined examination in the diagnosis of peripheral lung cancer[J]. Guangzhou Medical Journal, 2023, 54(3): 35-40.

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