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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2017, Vol. 10 ›› Issue (04) : 406 -409. doi: 10.3877/cma.j.issn.1674-6902.2017.04.006

所属专题： 文献；

论著

超细支气管镜联合EBUS-GS对周围型肺癌诊断效能及影响因素分析
房延凤1, 李王平1, 顾兴1, 潘蕾1, 张红军1,†(), 金发光1   
  1. 1. 710038　西安，第四军医大学唐都医院呼吸与危重症医学科
  • 收稿日期:2017-01-23 出版日期:2017-08-20
  • 通信作者: 张红军
  • 基金资助:
    国家公益性行业科研专项(201402024); 第四军医大学唐都医院面上项目(2015LCYJ005)

Analysis of diagnostic efficacy and influencing factors of ultrathin bronchoscopy combined with EBUS-GS in peripheral lung carcinoma

Yanfeng Fang1, Wangping Li1, Xing Gu1, Lei Pan1, Hongjun Zhang1,†(), Faguang Jin1   

  1. 1. Department of Pulmonary and Critical Care Medicine, TangDu Hospital, the Fourth Military Medical University, Xi′an 710038, China
  • Received:2017-01-23 Published:2017-08-20
  • Corresponding author: Hongjun Zhang
  • About author:
    Corresponding author: Zhang Hongjun, Email:
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引用本文：

房延凤, 李王平, 顾兴, 潘蕾, 张红军, 金发光. 超细支气管镜联合EBUS-GS对周围型肺癌诊断效能及影响因素分析[J]. 中华肺部疾病杂志(电子版), 2017, 10(04): 406-409.

Yanfeng Fang, Wangping Li, Xing Gu, Lei Pan, Hongjun Zhang, Faguang Jin. Analysis of diagnostic efficacy and influencing factors of ultrathin bronchoscopy combined with EBUS-GS in peripheral lung carcinoma[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2017, 10(04): 406-409.

目的

探讨超细支气管镜联合带引导鞘的支气管内超声(EBUS-GS)对周围型肺癌的诊断价值。

方法

纳入2015年8月至2016年6月就诊唐都医院呼吸科的高度疑似周围型肺癌患者208例(0.8 cm<直径<4 cm)，超细支气管镜联合EBUS-GS活检，进行良恶性病变诊断率的比较，不同影响因素下诊断率的比较及诊断效能的评价。

结果

208例患者中确诊肺癌180例，EBUS-GS对肺周围型恶性病变诊断率高于良性病变，有统计学差异(χ2＝3.884，P＝0.049)；病变距肺门距离≤4 cm、≤5 cm和≤6 cm的诊断率分别为88.158%、74.545%、55.102%，三组间卡方检验(χ2＝17.371，P＝0.000)，有统计学差异；有支气管充气征组与无支气管充气征组诊断率分别为84.906%、70.866%，两组间卡方检验(χ2＝3.931，P＝0.047)，有统计学差异；超细支气管镜联合EBUS-GS对周围型肺癌诊断敏感性75.000%，特异性92.857%，约登指数0.679。

结论

超细支气管镜联合EBUS-GS对周围型肺癌的诊断效能高，安全可靠。

关键词: 超细支气管镜, EBUS-GS, 周围型肺癌, 诊断效能, 影响因素
Objective

To evaluate the diagnostic value of ultrathin bronchoscopy and intrabronchial ultrasonography(EBUS-GS)combined with guide sheath in peripheral lung carcinoma.

Methods

208 cases of suspected peripheral lung cancer(0.8 cm<diameter<4 cm)were treated with ultrathin bronchoscopy combined with EBUS-GS biopsy from August 2015 to June 2016. The diagnostic rate of benign and malignant lesions were Comparison of different diagnostic factors and the diagnostic efficiency of the evaluation.

Results

One hundred and eighty cases of malignant tumors were diagnosed in 208 cases. The diagnostic rates of EBUS-GS in the pulmonary malignant lesions were higher than that in the benign lesions. There were significant differences(χ2=3.884, P=0.049). The diagnostic rates of the lesions from the hilum distance≤4 cm, ≤5 cm and≤6 cm were 88.158%, 74.545% and 55.102% respectively, there were significant differences(χ2=17.371, P=0.000). The diagnostic rates of bronchial aerated group and non-bronchial aerated group were 84.906%, 70.866% respectively, there were significant differences(χ2=3.93, P=0.047). The sensitivity of ultrathin bronchoscopy combined with EBUS-GS in the diagnosis of peripheral lung carcinoma was 75.000%, specificity was 92.857% and the index was 0.679.

Conclusions

Ultrathin bronchoscopy combined with EBUS-GS is a safe and reliable method for diagnosis of peripheral lung carcinoma.

Key words: Ultrathin bronchoscopy, EBUS-GS, Peripheral lung carcinoma, Diagnostic efficacy, Influencing factors
表1 208例病理结果及构成比的比较
病理类型及其他 例数 占总体比例(%) 占肺恶性肿瘤(%)
腺癌 115 55.288 63.889
鳞癌 19 9.135 10.556
转移瘤 14 6.731 7.778
非小细胞癌(未分型) 22 10.577 12.222
小细胞肺癌 10 4.808 5.556
结核 8 3.846 ?
肺真菌病 5 2.404 ?
肺部炎症 12 5.770 ?
肺错构瘤 1 0.481 ?
肺炎性假瘤 2 0.962 ?
表2 超细支气管镜联合EBUS-GS在肺部良恶性病变中诊断率的比较
组　别 病例数 诊断例数 诊断率(%) χ2值 P值
良性病变 28 16 57.143 3.884 0.049
恶性病变 180 135 75.000 ? ?
表3 超细支气管镜联合EBUS-GS在不同影响因素下诊断率的比较
组　别 项目 病例数 诊断例数 诊断率(%) χ2值 P值
直径大小 ≤2 cm 78 49 62.821 10.890 0.001
? >2 cm 102 86 84.314 ? ?
距肺门距离 ≤4 cm 76 67 88.158 17.371 0.000
? ≤5 cm 55 41 74.545 ? ?
? ≤6 cm 49 27 55.102 ? ?
支气管充气征 有 53 45 84.906 3.931 0.047
? 无 127 90 70.866 ? ?
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