Department of Pulmonary Medicine.
Department of Histopathology.
J Bronchology Interv Pulmonol. 2023 Oct 1;30(4):346-353. doi: 10.1097/LBR.0000000000000885.
There are few reports on the utility of bronchoscopic narrow-band imaging (NBI) for visualizing endobronchial abnormalities in sarcoidosis. Our primary objective was to compare the sensitivity of finding endobronchial abnormality using NBI versus white light bronchoscopy (WLB) in patients with sarcoidosis. The secondary aim was to evaluate the sensitivity of NBI in diagnosing endobronchial sarcoidosis against a reference standard of positive endobronchial biopsy (EBB).
We retrospectively included subjects with sarcoidosis, where we sequentially recorded WLB and NBI videos to visualize the endobronchial mucosa. We collected data on the demographic findings, sarcoidosis stage, and the histopathological findings of transbronchial needle aspiration, EBB, and transbronchial lung biopsy. Three experienced bronchoscopists viewed the video recordings and noted the abnormalities of the airway mucosa separately on WLB and NBI.
We included 28 subjects (mean age, 42.9 y; 53.6% men; 14 each, stages 1 and 2) with a final diagnosis of sarcoidosis. Granulomas were detected on EBB in 11 (39.3%) subjects. We identified endobronchial nodules in 10 and 15 subjects on WLB and NBI. The sensitivity of finding endobronchial abnormality using WLB and NBI was 35.7% (10/28) and 53.6% (15/28), respectively (χ 2 =1.77, df=1, P =0.18). The sensitivity of NBI in diagnosing endobronchial sarcoidosis against a positive EBB was 63.6% (7/11 subjects). There was excellent agreement (Κ=0.86) for detecting nodules on NBI among the 3 observers.
NBI might allow the identification of additional abnormalities not detected on WLB in sarcoidosis. Larger studies are required to confirm our observations.
有关支气管镜窄带成像（NBI）在结节病中观察支气管内异常的应用价值的报道较少。我们的主要目的是比较 NBI 与白光支气管镜（WLB）在结节病患者中发现支气管内异常的敏感性。次要目的是评估 NBI 在诊断支气管内结节病方面的敏感性，以支气管内活检（EBB）阳性作为参考标准。
我们回顾性纳入了结节病患者，对这些患者进行了 WLB 和 NBI 录像以观察支气管内黏膜。我们收集了人口统计学数据、结节病分期以及经支气管针吸活检、EBB 和经支气管肺活检的组织病理学数据。3 名经验丰富的支气管镜医生分别观看录像，并分别在 WLB 和 NBI 上记录气道黏膜的异常情况。
我们纳入了 28 例（平均年龄 42.9 岁；53.6%为男性；各 14 例，分期为 1 期和 2 期）最终诊断为结节病的患者。11 例（39.3%）患者的 EBB 中发现了肉芽肿。我们在 WLB 和 NBI 上分别发现了 10 例和 15 例支气管内结节。使用 WLB 和 NBI 发现支气管内异常的敏感性分别为 35.7%（28 例中有 10 例）和 53.6%（28 例中有 15 例）（χ 2 =1.77，df=1，P=0.18）。NBI 诊断支气管内结节病的敏感性为 63.6%（11 例中有 7 例），阳性 EBB 结果。3 名观察者在 NBI 上检测结节的一致性很好（Κ=0.86）。
NBI 可能可以识别 WLB 无法发现的结节病中的其他异常。需要更大的研究来证实我们的观察结果。
