Diagnostic accuracy and safety of flexible bronchoscopy with multiplanar reconstruction images and ultrafast Papanicolaou stain: evaluating solitary pulmonary nodules.
Diagnostic accuracy and safety of flexible bronchoscopy with multiplanar reconstruction images and ultrafast Papanicolaou stain: evaluating solitary pulmonary nodules.
复制标题
使用多平面重建图像和超快巴氏染色的柔性支气管镜的诊断准确性和安全性：评估孤立性肺结节。
DOI：
10.1378/chest.124.5.1985
复制
发表时间：
2003
期刊：
影响因子：
9.6
通讯作者：
T. Ishida
中科院分区：
文献类型：
--
作者：
S. Bandoh;J. Fujita;Yasunori Tojo;H. Yokomise;K. Satoh;Shoji Kobayashi;T. Ishida
学习目标
旨在评估使用多平面重建 (MPR) 图像和超快巴氏染色 (UFP) 染色的可弯曲支气管镜在评估孤立性肺结节 (SPN) 时的诊断准确性和安全性。
设计
2000 年 6 月至 2002 年 6 月期间进行的支气管镜检查前瞻性研究。
患者
一百名连续的 SPN 患者接受了 MPR 和 UFP 支气管镜检查（MPR 和 UFP 组）。历史控制数据是在 1997 年 7 月至 2000 年 6 月期间以回顾性方式收集的。
方法
从 MPR 获得的有关 SPN 主导支气管的所有信息均用于指导活检。通过刮匙活检获得的样本用 UFP 染色，并在支气管镜检查过程中由细胞病理学家进行评估。
结果
MPR和UFP组有88个恶性病灶和12个良性病灶，历史对照组中有97个恶性病灶和3个良性病灶。 MPR 和 UFP 组支气管镜检查的总诊断准确率 (91%) 显着高于历史对照组 (58%) [p < 0.05]。尽管历史对照组中支气管镜检查的检出率与病灶大小显着相关（p < 0.05），但 MPR 和 UFP 组的诊断检出率与病灶大小之间没有显着相关性。 MPR 和 UFP 组中 SPN < 4.0 cm 的诊断率显着高于历史对照组 (p < 0.05)。此外，MPR 和 UFP 组双上叶的诊断率显着高于历史对照组 (p < 0.05)。相反，MPR 和 UFP 组的并发症发生率 (2%) 显着低于历史对照组 (13%) [p < 0.05]。
结论
在可屈性支气管镜检查过程中结合使用 MPR 图像和 UFP，提高了使用双铰链刮匙评估 SPN 的诊断准确性和安全性。
STUDY OBJECTIVES
To assess the diagnostic accuracy and safety of flexible bronchoscopy with multiplanar reconstruction (MPR) images and ultrafast Papanicolaou (UFP) stain in evaluating solitary pulmonary nodules (SPNs).
DESIGN
Prospective study of bronchoscopies performed between June 2000 and June 2002.
PATIENTS
One hundred consecutive patients with SPNs underwent bronchoscopy with MPR and UFP (MPR and UFP group). The data on historical control were collected in a retrospective fashion, between July 1997 and June 2000.
METHOD
All information obtained from MPR regarding the leading bronchus of the SPNs was used to guide biopsy. Samples obtained by curette biopsies were stained with UFP and evaluated by a cytopathologist during the bronchoscopy procedure.
RESULTS
There were 88 malignant and 12 benign lesions in the MPR and UFP group, and 97 malignant and 3 benign lesions in the historical control group. The total diagnostic accuracy of bronchoscopy in the MPR and UFP group (91%) was significantly higher compared with the historical control group (58%) [p < 0.05]. Although the yield of bronchoscopy was significantly related to the lesion size in the historical control group (p < 0.05), there was no significant association between the diagnostic yield and lesion size in the MPR and UFP group. The diagnostic yield for SPNs < 4.0 cm in the MPR and UFP group was significantly higher compared with the historical control group (p < 0.05). In addition, the diagnostic yield in both upper lobes in the MPR and UFP group was significantly higher compared with the historical control group (p < 0.05). On the contrary, the complication rate was significantly lower in the MPR and UFP group (2%) compared with the historical control group (13%) [p < 0.05].
CONCLUSION
Combined use of the MPR image and UFP during flexible bronchoscopy improved diagnostic accuracy and safety in evaluating SPNs using a double-hinged curette.