Value of virtual bronchoscopic navigation and transbronchial ultrasound-guided sheath-guided exploration in diagnosis of peripheral lung cancer

BACKGROUND Peripheral lung cancer poses a substantial harm to human health,and it is easy to become exacerbated,potentially threatening the life and safety of patients AIM To assess the value of virtual bronchoscopic navigation(VBN)combined with transbronchial ultrasound-guided sheath-guided(EBUS-GS)exploration in the diagnosis of peripheral lung cancer.METHODS A total of 236 patients with peripheral lung cancer(nodule diameter range,8-30 mm;diagnosed using high-resolution computed tomography)were selected from three centers between October 2018 and December 2019.Patients who underwent EBUS-GS exploration alone were included in a control group,and those who received VBN in combination with EBUS-GS exploration were included in an observation group.The diagnostic rate and total operating time of differentsubgroups of the two groups were compared,and the time needed to determine the lesion was recorded.RESULTS There were no significant differences in diagnosis rate or total operation time between the two groups(P>0.05),and the time needed to determine the lesion in the observation group was less than that of the control group(P<0.05).CONCLUSION The combined use of VBN and EBUS-GS exploration technology has little effect on the diagnosis rate and total operation time of peripheral lung cancer,but it significantly shortens the time needed to determine the lesion and is a valuable diagnostic method.

The diagnostic rules of peripheral lung cancer preliminary study based on data mining technique

Objective： To discuss the clinical and imaging diagnostic rules of peripheral lung cancer by data mining technique, and to explore new ideas in the diagnosis of peripheral lung cancer, and to obtain early-stage technology and knowledge support of computer-aided detecting （CAD）. Methods： 58 cases of peripheral lung cancer confirmed by clinical pathology were collected. The data were imported into the database after the standardization of the clinical and CT findings attributes were identified. The data was studied comparatively based on Association Rules （AR） of the knowledge discovery process and the Rough Set （RS） reduction algorithm and Genetic Algorithm（GA） of the generic data analysis tool （ROSETTA）, respectively. Results： The genetic classification algorithm of ROSETTA generates 5 000 or so diagnosis rules. The RS reduction algorithm of Johnson＇s Algorithm generates 51 diagnosis rules and the AR algorithm generates 123 diagnosis rules. Three data mining methods basically consider gender, age, cough, location, lobulation sign, shape, ground-glass density attributes as the main basis for the diagnosis of peripheral lung cancer. Conclusion： These diagnosis rules for peripheral lung cancer with three data mining technology is same as clinical diagnostic rules, and these rules also can be used to build the knowledge base of expert system. This study demonstrated the potential values of data mining technology in clinical imaging diagnosis and differential diagnosis.

Diagnostic value of transbronchial lung biopsy in peripheral lung cancer

Objective: The purpose of this study was to evaluate the diagnostic value of transbronchial lung biopsy (TBLB) in peripheral lung cancer. Methods: 78 cases of peripheral lung cancer which could not be observed by bronchoscope were selected from the Second Affiliated Hospital of Sun Yat-sen University (China), of which 42 cases were diagnosed by TBLB. Among the 36 cases of peripheral lung cancer that could not be able to be diagnosed by TBLB, 22 cases were diagnosed by percutaneous lung biopsy (PNLB) and 14 cases being left were diagnosed by surgical specimens biopsy, lymphadenopathy biopsy, pleural biopsy or pleural effusion cytology. Results: The positive rates produced by TBLB and transbronchial brush biopsy were 53.8% and 8.9%, respectively, and the combined positive rate was 57.7%. The positive rate produced by TBLB was higher than that of transbronchial brush biopsy (P < 0.01). As the tumor’s diameter increased, the positive rate of the biopsy was higher (P < 0.05). The positive rate of biopsy of the right lung was not significantly higher than that of the left lung (P > 0.05). The positive rate of biopsy of the inferior lobes was not significantly higher than that of the upper lobes of the lung (P > 0.05). The lesions of the tumors which were nearer to the infield and hilar of the lung got a higher positive rate (P < 0.01). The incidence of complications in PNLB was much higher than that in TBLB (P < 0.05). Conclusion: TBLB is an important method in the diagnosis of peripheral lung cancer. Combination of TBLB and other methods can increase the positive rate in the diagnosis of peripheral lung cancer.

Risk factors for occult nodal metastasis in patients with stage ⅠA peripheral non-small cell lung cancer

Objective To study the risk factors of mediastinal lymph node metastasis in patients with ≤3 cm peripheral non small cell lung cancer. Methods From January 2000 to December 2010,a total of 281 patients with NSCLC [152 men and 129 women,aged (60. 31 ± 12. 13) years; ≤ 3 cm in diameter]underwent lobectomy or partial resection with systematic mediastinal lymphadenectomy in hospital. Clinical data included age,gender,

Clinical experiences with 20 cases of single-direction thoracoscopic lobectomy and systematic lymph node dissection for peripheral NSCLC

Objective: To evaluate the safety, efficacy, feasibility of single-direction thoracoscopic lobectomy for peripheral lung cancer. Methods: From December 2009 to March 2011, 20 patients with peripheral lung cancer were treated with single-direction thoracoscopic lobectomy and systemic lymph nodes dissection. Results: Surgeries were successfully performed. No significant complications occurred perioperatively. The average operation time was 193 min, the average blood loss was 234 ml, the average duration of drainage was 6 d, the postoperative hospital stay was 12 d, and the average number of lymph nodes dissected was 16. Conclusion: Single-direction thoracoscopic lobectomy is feasible and safe in the treatment of peripheral lung cancer and can simplify the surgical procedures.