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经支气管超声引导下使用新型纤支镜经支气管透壁活检术诊断周围型肺部病变。

Endobronchial ultrasound-guided transbronchial biopsy using novel thin bronchoscope for diagnosis of peripheral pulmonary lesions.

机构信息

Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan.

出版信息

J Thorac Oncol. 2009 Oct;4(10):1274-7. doi: 10.1097/JTO.0b013e3181b623e1.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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