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比较半硬性和硬性胸腔镜检查在渗出性淋巴细胞为主型胸腔积液诊断中的诊断准确性。

Comparing the diagnostic accuracy of semi-rigid and rigid pleuroscopy in diagnosis of exudative lymphocyte dominant pleural effusion with.

作者信息

Borsi Hamid, Farahnak Mohammad Reza, Raji Hanieh, Shooshtari Maryam Haddadzadeh, Pirhayati Behnam

机构信息

Department of Pulmonology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Department of Thoracic Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Family Med Prim Care. 2020 Oct 30;9(10):5256-5260. doi: 10.4103/jfmpc.jfmpc_703_20. eCollection 2020 Oct.

Abstract

BACKGROUND AND OBJECTIVES

Pleuroscopy is an appropriate technique for visualization and biopsy of the pleural lesions, performed by two different techniques. In this study, we aimed to investigate the diagnostic accuracy of semi-rigid and rigid pleuroscopy in patients with lymphocyte dominant exudative pleural effusion.

MATERIALS AND METHODS

In this study, patients with lymphocyte dominant pleural effusion with negative results for tuberculosis who referred to Imam Khomeini Hospital, Ahvaz, Iran; from 2018 to 2019 were selected by census method and randomized to undergo semi-rigid or rigid pleuroscopy (30 in each group). Patients' demographic, such as age and gender, were recorded and the pathologic results reported by the two pleuroscopy methods were compared and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were reported for each method. All statistical analyses were performed using SPSS v. 21.

RESULTS

Thirty patients were included in each group. The frequency of tuberculosis, malignancy, and other causes of pleural effusion had no difference between the two methods ( > 0.05). Semirigid pleuroscopy had a sensitivity of 81.5%, specificity of 66.6%, PPV of 75.6%, and NPV of 74%, while the relevant values in rigid pleuroscopy were 87.2%, 68.4%, 87.2%, and 68.4%, respectively.

CONCLUSION

These results, consistent with previous studies, indicated that both semi-rigid and semi-flexible pleuroscopy methods are accurate for diagnosis of lymphocyte dominant pleural effusion when performed by skilled specialists and other considerations, such as availability and costs, can be used for selection of each method.

摘要

背景与目的

胸腔镜检查是一种通过两种不同技术对胸膜病变进行可视化和活检的合适技术。在本研究中,我们旨在探讨半硬性和硬性胸腔镜检查对淋巴细胞为主的渗出性胸腔积液患者的诊断准确性。

材料与方法

在本研究中,采用普查法选取2018年至2019年转诊至伊朗阿瓦士伊玛目霍梅尼医院、胸腔积液以淋巴细胞为主且结核检查结果为阴性的患者,并将其随机分为半硬性或硬性胸腔镜检查组(每组30例)。记录患者的人口统计学信息,如年龄和性别,并比较两种胸腔镜检查方法报告的病理结果,报告每种方法的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)。所有统计分析均使用SPSS v. 21进行。

结果

每组纳入30例患者。两种方法在结核、恶性肿瘤及其他胸腔积液病因的检出率上无差异(>0.05)。半硬性胸腔镜检查的敏感性为81.5%,特异性为66.6%,PPV为75.6%,NPV为74%,而硬性胸腔镜检查的相关值分别为87.2%、68.4%、87.2%和68.4%。

结论

这些结果与先前的研究一致,表明当由熟练的专家进行操作时,半硬性和半柔性胸腔镜检查方法对于诊断淋巴细胞为主的胸腔积液都是准确的,并且可以根据可用性和成本等其他因素来选择每种方法。

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