Tuta-Quintero Eduardo, Giraldo-Cadavid Luis F, Sanmiguel-Reyes Catalina, Navia Maria E, Cardenas Ricardo, Bastidas Alirio, Mora Angelica, Páez-Espinel Nelson, Viola Lucía, Suárez Miguel, Jiménez-Maldonado Libardo, Durán Mauricio, Mugnier Jacqueline, Flandes Javier
School of Medicine, Universidad de La Sabana, Bogotá Colombia, Chia, Colombia.
Interventional Pulmonology, Fundación Neumológica Colombiana, Bogotá, Colombia.
Ther Adv Respir Dis. 2025 Jan-Dec;19:17534666251357699. doi: 10.1177/17534666251357699. Epub 2025 Aug 1.
Radial endobronchial ultrasound (r-EBUS) is a minimally invasive procedure used to evaluate pulmonary lesions suspicious of cancer. Current information on the effect of combining different sampling tools used during r-EBUS or the addition of linear EBUS (EBUS-TBNA) on its diagnostic performance is limited.
To evaluate the effect on diagnostic performance of the systematic addition of different sampling tools and EBUS-TBNA during r-EBUS, as well as the rate of peri-procedural complications.
This was an observational, analytical cohort study designed to evaluate diagnostic accuracy.
We calculated diagnostic accuracy statistics and used the Cochran-Armitage statistical test to assess the effect of combining techniques on diagnostic performance. Diagnostic success (DS) was defined as true positives and true negatives, while diagnostic failure was defined as false positives and false negatives.
A total of 309 patients were included, with a mean age of 67.9 years (standard deviation: 10.97); 50.8% (157/309) were male. The bronchial washing had a DS rate of 49%, while bronchial brushing showed a DS rate of 61%. The combination of bronchial washing and bronchial brushing improved the r-EBUS performance to 63%. Combining bronchial washing, bronchial brushing, and transbronchial biopsy increased the performance to 70%, and the addition of EBUS-TBNA raised the diagnostic performance to 80% ( < 0.001; Cochran-Armitage test). The overall complication rate was 6.4% (20/309), with pneumothorax occurring in 1.2% (4/309), bronchospasm in 3.8% (12/309), and bleeding in 1.2% (4/309).
The use of multiple sampling tools significantly contributes to the DS of r-EBUS, particularly with the addition of EBUS-TBNA. This approach maintains a low complication rate.
径向支气管内超声（r-EBUS）是一种用于评估可疑肺癌性肺病变的微创检查方法。目前关于在r-EBUS检查过程中联合使用不同采样工具或增加线性EBUS（EBUS-TBNA）对其诊断性能影响的信息有限。
评估在r-EBUS检查过程中系统地增加不同采样工具和EBUS-TBNA对诊断性能的影响，以及围手术期并发症发生率。
这是一项旨在评估诊断准确性的观察性分析队列研究。
我们计算了诊断准确性统计数据，并使用 Cochr an-Armitage 统计检验来评估联合技术对诊断性能的影响。诊断成功（DS）定义为真阳性和真阴性，而诊断失败定义为假阳性和假阴性。
共纳入309例患者，平均年龄67.9岁（标准差：10.97）；50.8%（157/309）为男性。支气管灌洗的诊断成功率为49%，而支气管刷检的诊断成功率为61%。支气管灌洗和支气管刷检联合使用可将r-EBUS的诊断性能提高到63%。支气管灌洗、支气管刷检和经支气管活检联合使用可将诊断性能提高到70%，增加EBUS-TBNA可将诊断性能提高到80%（P<0.001； Cochr an-Armitage检验）。总体并发症发生率为6.4%（20/309），气胸发生率为1.2%（4/309），支气管痉挛发生率为3.8%（12/309），出血发生率为1.（4/309）。
使用多种采样工具对r-EBUS的诊断成功有显著贡献，尤其是增加EBUS-TBNA时。这种方法并发症发生率较低。
