以EBUS为指导的横支气管中结晶活检用于诊断非转移性淋巴腺病:一种随机对照试验
Mingming Deng1, Ziwen Zheng2, Xiaofei Zhang3
1National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, P.R. China.
与EBUS-transbronchial needle aspiration (EBUS-TBNA) 相比,内支气管超声波导向的横支气管中腔冷活检 (EBUS-TBMC) 在非转移性淋巴腺病的诊断收益率更高. 作为一种主要的诊断工具,EBUS-TBMC显示出前景.
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
- 诊断成像 诊断成像 诊断成像
背景情况:
- 诊断非转移性淋巴腺病变会带来重大的临床挑战.
- 导向内支气管超声波 (EBUS) 导向的横支气管中腔冷活检 (TBMC) 与EBUS-横支气管针吸收 (TBNA) 的比较诊断准确性尚未得到充分证实.
研究的目的:
- 为了比较EBUS-TBMC和EBUS-TBNA对非转移性淋巴腺病的诊断产量.
- 评估EBUS-TBMC作为潜在的一线诊断模式的有效性.
主要方法:
- 一个多中心随机试验,涉及患有需要诊断支气管镜检查的中/耳部病变的患者.
- 患者被随机分配到EBUS-TBNA-第一组或EBUS-TBMC-第一组.
- 主要终点是每个程序的诊断收益率.
主要成果:
- 与EBUS-TBNA (79.9%) 相比,EBUS-TBMC在良性病因和淋巴瘤方面取得了明显更高的整体诊断收益率 (97.1%).
- 对于 Sarcoidosis 诊断,EBUS-TBMC 的灵敏度 (98.0%) 和 EBUS-TBNA 的灵敏度 (82.7%) (p < 0.001) 相比,EBUS-TBMC 的灵敏度更高.
- 所有参与者都只经历了1级呼吸道出血,这表明了有利的安全概况.
结论:
- 在诊断非转移性淋巴腺病变方面,EBUS-TBMC显著优于EBUS-TBNA,特别是在肉类发病病例中.
- 由于其高诊断产量和良好的安全性,EBUS-TBMC是推的一线诊断方法.
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