Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan.
J Thorac Oncol. 2009 Oct;4(10):1274-7. doi: 10.1097/JTO.0b013e3181b623e1.
The aim of this study was to evaluate the diagnostic utility of endobronchial ultrasound (EBUS)-guided transbronchial biopsy (TBB) using a novel 3.4-mm thin bronchoscope and a 1.4-mm ultrasonic probe for peripheral pulmonary lesions.
A total of 86 patients with suspected peripheral lesions were included in this prospective study. EBUS-TBBs were performed using a prototype 3.4-mm thin bronchoscope and a 1.4-mm radial ultrasonic probe under fluoroscopic guidance.
Twelve patients with endobronchial lesions within the segmental bronchi and three patients who did not return to follow-up were excluded from this analysis. Thus, a total of 71 patients with peripheral pulmonary lesions (mean size, 31.2 +/- 12.7 mm) were included in the final analysis. The mean bronchus level reached with the thin bronchoscope was 4.6 generations. Diagnostic histologic specimens were obtained in 49 of 71 patients (69%:80% for malignant lesions and 52% for benign lesions). A definitive diagnosis of malignancy for lesions > or =20 mm and lesions < 20 mm was made in 82% (31 of 38) and 67% (four of six), respectively. There were no significant complications.
The EBUS-TBB using a 3.4-mm thin bronchoscope and a 1.4-mm radial probe is feasible, accurate, and safe for the diagnosis of peripheral pulmonary lesions.
本研究旨在评估使用新型 3.4mm 纤支镜和 1.4mm 超声探头进行经支气管超声引导下经支气管针吸活检(EBUS-TBB)对周围性肺部病变的诊断效用。
本前瞻性研究共纳入 86 例疑似周围性病变患者。在透视引导下,使用原型 3.4mm 纤支镜和 1.4mm 径向超声探头进行 EBUS-TBB。
12 例存在支气管内节段性病变的患者和 3 例未进行随访的患者被排除在本分析之外。因此,共有 71 例周围性肺部病变患者(平均大小为 31.2±12.7mm)纳入最终分析。纤支镜平均可达支气管 4.6 级。49 例患者(69%:恶性病变为 80%,良性病变为 52%)获得了明确的组织学诊断。对于 >20mm 和 <20mm 的病变,其恶性病变的明确诊断率分别为 82%(31/38)和 67%(4/6)。无明显并发症。
使用 3.4mm 纤支镜和 1.4mm 径向探头的 EBUS-TBB 对于周围性肺部病变的诊断是可行、准确和安全的。