Department of Pneumology, CHU Rouen, Rouen, France.
Department of Pathology, CHU Rouen, Rouen, France.
Thorac Cancer. 2022 Oct;13(20):2854-2860. doi: 10.1111/1759-7714.14629. Epub 2022 Aug 29.
Various advanced bronchoscopy methods have been developed to reach peripheral lung lesions (PLL). In a large cohort, we aimed to assess a standardized procedure of first-line radial-endobronchial ultrasound (r-EBUS) and virtual bronchoscopy planner for the diagnosis of peripheral lung cancer.
This retrospective, single center study included patients who had r-EBUS-guided bronchoscopy for the diagnosis of a PLL between 2008 and 2019. Cases without a final diagnosis of cancer or follow-up were excluded.
Between 2008 and 2019, 2735 patients had a r-EBUS procedure, among whom 1627 had a final diagnosis of cancer and were included in the present study. Over the 12-year study period, r-EBUS became the first-line endoscopic procedure to assess PLL (25% as first-line bronchoscopy in 2008 vs. 92% in 2019). The frequency of the bronchus sign decreased from 2009 to 2019 (100% to 80%; p = 0.001), whereas US visualization of the lesion remained stable (88%). The median number of biopsies increased from two (2008 to 2014) to four (2015 to 2019) (p < 0.0001), with the same diagnostic efficiency (74% total and 80% when a bronchus sign was present). Of the 651 adenocarcinomas, molecular analysis was possible in 86%. PD-L1 expression analysis was possible in 81% of cases. During the study period, the lifetime of the radial probe increased from 57 procedures to 77 procedures/probe.
Because r-EBUS and VB planner is easy to perform under local anesthesia, inexpensive and efficient it can be used as a first-line procedure to assess peripheral lung cancer.
已经开发了各种先进的支气管镜方法来到达外周肺病变（PLL）。在一项大型队列研究中，我们旨在评估一种标准化的一线径向支气管内超声（r-EBUS）和虚拟支气管镜规划程序，用于诊断外周肺癌。
本回顾性单中心研究纳入了 2008 年至 2019 年间接受 r-EBUS 引导下支气管镜检查以诊断 PLL 的患者。排除无癌症最终诊断或随访的病例。
2008 年至 2019 年间，2735 例患者接受了 r-EBUS 检查，其中 1627 例最终诊断为癌症，纳入本研究。在 12 年的研究期间，r-EBUS 成为评估 PLL 的一线内镜程序（2008 年作为一线支气管镜检查的 25%，2019 年为 92%）。支气管征的频率从 2009 年到 2019 年下降（100%降至 80%；p=0.001），而病变的 US 可视化保持稳定（88%）。活检的中位数从 2 个（2008 年至 2014 年）增加到 4 个（2015 年至 2019 年）（p<0.0001），但诊断效率相同（总 74%，支气管征存在时为 80%）。在 651 例腺癌中，86%可进行分子分析。81%的病例可进行 PD-L1 表达分析。在研究期间，径向探头的使用寿命从 57 次增加到 77 次/探头。
由于 r-EBUS 和 VB 规划器易于在局部麻醉下进行，并且价格低廉且高效，因此可以用作评估外周肺癌的一线程序。
