径向超声导引鞘在周围型肺癌诊断中的价值

Diagnosis value of radial ultrasonic probe guiding sheath in peripheral lung cancer

目的:比较传统经支气管镜肺活检(TBLB)、径向超声引导的肺活检(RP-EBUS-TBLB)对周围型肺癌的诊断差异,探讨抛弃式超声探头导引鞘(GS)的临床使用价值。方法:回顾分析经支气管镜检查的268例周围性肺癌患者的临床资料,按照不同的检查方法分为TBLB组(107例)、RP-EBUS-TBLB组(104例)和GS-RP-EBUS-TBLB(57例)三组,比较各组之间的诊断率,分析其相关影响因素。结果:1.TBLB、RP-EBUSTBLB和GS-RP-EBUS-TBLB组的诊断阳性率分别为45.8%、61.5%和63.2%,和TBLB相比差异均有统计学意义(P<0.05);2.GS-RP-EBUS-TBLB组和RP-EBUS-TBLB组刷检阳性率分别为52.7%和41.0%,差异有统计学意义(P<0.05);3.GS-RP-EBUS-TBLB和RP-EBUS-TBLB组在半实性、支气管征阴性和超声毗邻型病灶的刷检阳性率分别为66.7%和53.3%、25.0%和18.2%、58.3%和39.4%,差异有统计学意义(P<0.05)。结论:GS-RP-EBUS-TBLB可以提高周围性肺癌刷检阳性率,增加半实性、支气管征阴性和超声毗邻型病灶的诊断阳性率。

Objective: To compare the diagnostic difference of peripheral lung cancer between traditional transbronchial lung biopsy( TBLB) group and radial ultrasound probe guided lung biopsy( RP-EBUS-TBLB) group,to explore the clinical value of disposable ultrasonic probe sheath( GS). Methods: According to the different check methods,268 cases of peripheral lung cancer patients were divided into TBLB group( 107 cases),RP-EBUS-TBLB group( 104 cases) and GS-RP-EBUS-TBLB( 57 cases) group. Retrospective analysis was used to compare the different diagnosis rates and analyzed the related factors. Results: 1. The positive diagnosis rate of TBLB,RP-EBUSTBLB and GS-RP-EBUS-TBLB group was 45. 8%,61. 5% and 63. 2% respectively( P < 0. 05); 2. The brushing positive rate of GS-RP-EBUS-TBLB and RP-EBUS-TBLB group was 52. 7% and 41% respectively( P < 0. 05);3. The brushing positive rate of GS-RP-EBUS-TBLB vs RP-EBUS-TBLB group in subsolid lesion,negative bronchial sign lesion and ultrasound adjacent type lesion were 66. 7% vs 53. 3%,25% vs 18. 2%,58. 3% vs 39. 4%,the difference were statistically significant( P < 0. 05). Conclusion: GS-RP-EBUS-TBLB can improve the brushing positive rate,but it does not increase the overall diagnostic positive rate of peripheral lung cancer.