变革肺癌诊断：机器人辅助支气管镜检查在早期检测和分期中的作用。

Transforming lung cancer diagnosis: the role of robotic-assisted bronchoscopy in early detection and staging.

作者信息

Fernandez-Bussy Sebastian, Funes-Ferrada Rodrigo, Yu Lee-Mateus Alejandra, Vaca-Cartagena Bryan F, Barrios-Ruiz Alanna, Valdes-Camacho Sofia, Patel Neal M, Husta Bryan C, Hazelett Britney N, Ibrahim Mohamed I, Robertson Kelly S, Chadha Ryan M, Abia-Trujillo David

机构信息

Division of Pulmonary, Allergy, and Sleep Medicine, Mayo Clinic Florida, Jacksonville, FL, USA.

出版信息

Lung Cancer. 2025 Aug;206:108646. doi: 10.1016/j.lungcan.2025.108646. Epub 2025 Jun 27.

DOI:10.1016/j.lungcan.2025.108646

PMID:40602203

Abstract

INTRODUCTION

Minimally invasive techniques, including CT-guided transthoracic biopsy (CTTB) and robotic-assisted bronchoscopy (RAB), play a crucial role in diagnosing peripheral pulmonary lesions suspected of lung cancer. This article aims to assess differences in primary lung cancer diagnosis and staging between patients undergoing ssRAB with shape-sensing RAB (ssRAB) and CTTB.

METHODS

This retrospective cohort study included 407 patients who underwent CTTB (2017-2020) and 556 who underwent ssRAB (2020-2023) at a single institution. Propensity score matching (1:1) was applied to balance baseline covariates. Outcomes included cancer stage at diagnosis, procedural safety, and hospital metrics. Logistic regression and descriptive statistics were used to analyze differences.

RESULTS

After matching, 148 patients per group were analyzed. Patients in the ssRAB group were more frequently diagnosed at an early stage compared to the CTTB group (OR = 3.02, 95 % CI: 1.83-5.04, p < 0.001). ssRAB demonstrated significantly lower rates of pneumothorax (3.38 % vs. 44.59 %, p < 0.001) and hospital admissions (5.41 % vs. 19.59 %, p < 0.001). Despite longer procedural times, ssRAB reduced hospital stays by 34 min (p < 0.001). Diagnostic yield for malignancy was comparable between ssRAB and CTTB (86.48 % vs. 89.18 %, p = 0.594).

CONCLUSION

ssRAB significantly improves early-stage lung cancer detection and reduces procedural risks, offering a safer, patient-centered approach. Its integration into diagnostic pathways represents a transformative advancement in lung cancer care. Further studies are warranted to confirm its broader impact across diverse healthcare settings.

摘要

引言

包括CT引导下经胸壁活检（CTTB）和机器人辅助支气管镜检查（RAB）在内的微创技术在诊断疑似肺癌的周围性肺病变中起着至关重要的作用。本文旨在评估接受带有形状感知功能的机器人辅助支气管镜检查（ssRAB）的患者与接受CTTB的患者在原发性肺癌诊断和分期方面的差异。

方法

这项回顾性队列研究纳入了在单一机构接受CTTB（2017 - 2020年）的407例患者和接受ssRAB（2020 - 2023年）的556例患者。采用倾向得分匹配（1:1）来平衡基线协变量。结果包括诊断时的癌症分期、操作安全性和医院指标。使用逻辑回归和描述性统计分析差异。

结果

匹配后，每组分析148例患者。与CTTB组相比，ssRAB组患者更常被诊断为早期（比值比 = 3.02，95%置信区间：1.83 - 5.04，p < 0.001）。ssRAB显示气胸发生率（3.38%对44.59%，p < 0.001）和住院率（5.41%对19.59%，p < 0.001）显著更低。尽管操作时间更长，但ssRAB使住院时间缩短了34分钟（p < 0.001）。ssRAB和CTTB之间恶性肿瘤的诊断率相当（86.48%对89.18%，p = 0.594）。