在辐射内支气管超声波期间,结核周围肺病变的预测因素
Sze Shyang Kho1, Swee Kim Chan1, Siew Teck Tie1
1Division of Respiratory Medicine, Department of Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia.
Respiratory medicine
|September 12, 2024
概括
在外周肺部病变 (TB-PPL) 结核病的预测因素是使用辐射内支气管超声波 (rEBUS) 确定. 年轻的年龄,较小的病变大小,上叶位置,化和REBUS支气管预测TB-PPL,提高程序安全.
科学领域:
- 肺部病理学 肺部病理学
- 干预性肺病学 干预性肺病学
- 传染性疾病 传染性疾病
背景情况:
- 结核病呈现为外围肺病变 (TB-PPL) 提出了诊断方面的挑战.
- 辐射内支气管超声波 (rEBUS) 越来越多地用于外周肺病变活检.
- 确定TB-PPL的预测因素对于确保rEBUS程序的安全至关重要.
研究的目的:
- 确定在周围肺病变 (TB-PPL) 中结核病的独立临床预测因子.
- 评估这些预测因子在指导放射性内支气管超声波 (rEBUS) 程序的安全性方面的实用性.
主要方法:
- 在2016年10月至2022年12月期间,针对外周肺病变 (PPLs) 接受REBUS治疗的成年患者的回顾性评估.
- 对387名PPL患者的临床,放射学,程序,组织学和微生物学的数据进行分析 (32%的TB-PPL,68%的恶性-PPL).
- 多变量分析以确定结核病-PPL的独立预测因子.
主要成果:
- 整体rEBUS诊断收益率为85.3%,肺胸风险为1.3%.
- 结核病-PPL的独立预测因素包括年龄<60岁,目标病变大小<2厘米,上叶的位置,CT上空腔的存在和rEBUS支气管.
- 该预测模型实现了0.729的AUC,诊断准确率为75.49%.
结论:
- 年龄较小,病变尺寸较小 (<2厘米),上叶部位,腔化和REBUS支气管是TB-PPL的重要预测因素.
- 这种预测模型有可能减轻在支气管镜检查过程中意外暴露于结核病的风险.
- 需要进行前性研究来验证这些发现,并完善用于rEBUS手术的患者分组.
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