摘要
目的探讨虚拟支气管镜导航(VBN)联合经支气管超声导向鞘引导(EBUS-GS)探查技术在,诊断周围型肺癌中的价值。方法随机将385例周围型肺癌(高分辨CT诊断,8 mm≤结节直径≤30mm)患者分为3组,一组为VBN联合EBUS-GS组,一组为EBUS-GS组,另一组为常规支气管镜组。在VBN联合EBUS-GS组,支气管镜经VBN引导到达靶支气管,并用超声探头探查;EBUS-GS组只有超声探头探查,无VBN辅助;常规支气管镜组,则既无VBN辅助,亦无超声探查,仅有胸部CT片作为参考。结果可供分析的研究对象为最后诊断为原发性周围型肺癌的294例患者。VBN联合EBUS-GS组与EBUS-GS组在诊断率方面无显著差异(82.5%/81.3%,P>0.05)。而与常规支气管镜组相比,诊断率有显著差异(82.5%/81.3%/43.3%,P<0.05)。亚组分析显示,影响VBN联合EBUS-GS组和EBUS-GS组诊断率的因素,可能为CT影像显示有支气管直通病变,病变直径大于20 mm,超声探头是否在病变内。结论 VBN联合EBUS-GS或EBUS-GS可提高周围型肺癌的诊断率;提高其诊断率的影响因素可能包括,CT影像显示有支气管直通病变,病变直径大于20 mm,超声探头是否在病变内。
Objective Virtual bronehoscopic navigation （VBN） can guide a bronchoscope under direct observation using virtual bronchoseopic images, VBN may be useful in diagnosing pulmonary lesions when combined with Endobronchial ultrasonography with a guide sheath （EBUS-GS）. To evaluate the value of VBN- assisted EBUS-GS for diagnosing peripheral lung cancer. Methods All 385 patients with peripheral lung cancer diagnosed with HRCT（ 8 mm ≤ diameter ≤ 30 mm） were randomly assigned to VBN-assisted EBUS-GS group, non-VBN-assisted EBUS-GS group or conventional bronchoscopy group. Results Subjects for analysis include 294 patients diagnosed as primary lung cancer finally. There was no significant difference in the diagnostic yield between the VBN-assisted EBUS-GS group and the non-VBN-assisted EBUS-GS group（ 82.5%/ 81.3%, P〉0.05）, but compared with conventional bronchoscopy group, the VBN-assisted EBUS-GS group and the non-VBN-assisted EBUS-GS group had a significantly higher diagnostic yield（82.5%/81.3%/43.3%, P〈 0.05）. The subgroup analysis showed that the following factors were associated with a significantly higher diagnostic yield： CT bronchus sign positivity, a lesion of 〉 20 mm in diameter and a probe position that was within the lesion. Conclusions VBN-assisted EBUS-GS or EBUS-GS improves the diagnostic yield for peripheral lung cancer. The significant factors that were significantly associated with a successful diagnosis using EBUS-GS-guided TBB in peripheral lung cancer were as follows： CT bronchus sign positivity, a lesion of 〉20 mm in diameter and a probe position that was within the lesion.
出处
《中华肺部疾病杂志（电子版）》
CAS
2017年第2期124-129,共6页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
国家公益性行业科研专项(201402024)
关键词
经支气管超声导向鞘引导
虚拟支气管镜导航
支气管肺癌
经支气管镜活检
Endobronchial ultrasonography with a guide sheath
Virtual bronchoscopic navigation
Bronchus lung cancer
Transbronehial biopsy
