支气管镜术在肺切除后新出现的外周肺病变的诊断实用性
Takahiro Suzuki1,2, Yuji Matsumoto1,3, Hideaki Furuse1
1Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Translational lung cancer research
|April 18, 2025
概括
支气管镜检查是癌症手术后诊断新肺病变的安全和有效方法. 然而,当活检取出与之前手术相同的侧面时,诊断准确性会降低.
科学领域:
- 肺部病理学 肺部病理学
- 在瘤学瘤学.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 肺癌切除后对周围肺病变 (PPLs) 的准确诊断对于患者的治疗结果至关重要.
- 手术后的PPL需要及时和精确的诊断来指导进一步的治疗.
- 在之前的胸部手术的背景下评估PPL的诊断方法具有临床意义.
研究的目的:
- 评估PPL患者在恶性瘤肺切除后的支气管镜检查的诊断效用和安全性.
- 为了研究之前的ipsilateral或contralateral肺切除对支气管镜诊断性能的影响.
主要方法:
- 对连续接受放射性内支气管超声波 (R-EBUS) 引导的PPL肺切除后跨支气管活检的患者进行回顾性分析.
- 与之前的手术相关的ipsilateral和contralateral活检患者之间的诊断产量的比较.
- 多变量分析以确定与诊断产量相关的因素.
主要成果:
- 经过支气管镜检查的PPL的整体诊断收益率为71.8% (158/220名患者).
- 在ipsilateral活检组 (62.7%) 的诊断产量明显低于逆侧活检组 (80.9%).
- 与较低产量相关的因素包括ipsilateral活检,负支气管征兆和病变位置.
结论:
- 支气管镜检查证明了肺癌手术后PPL患者的足够的诊断产量和安全性.
- 之前的ipsilateral肺切除会对PPL的支气管镜检查的诊断性能产生负面影响.
- 在解释术后PPL的支气管镜检查结果时,需要仔细考虑之前的手术部位.
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