A analysis on the consistency between bronchoscopy results and clinical diagnosis: A retrospective study of 936 patients

doi:10.3877/cma.j.issn.1674-6902.2026.02.017

Abstract

Abstract:

Objective

Bronchoscopy is of clinical significance in the diagnosis of respiratory diseases. This study aims to investigate the consistency between bronchoscopy findings and clinical diagnosis, as well as the change of the associated inflammatory markers.

Methods

A retrospective analysis was conducted on 936 patients who underwent bronchoscopy in the Department of Respiratory and Critical Care Medicine of our hospital. Among them, 704 patients with qualified bronchoalveolar lavage fluid (BALF) were divided into a positive group (440 cases) and a negative group (264 cases) for comparison of clinical characteristics.

Results

The sensitivity of bronchoscopy was 68.40%, specificity was 97.10%, and the overall concordance rate was 75.70% (P<0.001). There were no statistically significant differences in gender or age between the 704 BALF-positive and BALF-negative patients (P>0.05). Statistically significant differences were observed between the positive group and the negative group in terms of hypersensitive C-reactive protein (hs-CRP)[12.28(2.77, 83.49)mg/L vs. 7.22(1.00, 52.37)mg/L], white blood cell count [(9.33±6.03)×10⁹/L vs. (7.88±3.49)×10⁹/L], lymphocyte count [(1.14±0.63)×10⁹/L vs. (1.37±0.60)×10⁹/L], erythrocyte sedimentation rate (ESR)[31.0(9.0, 70.5)mm1 h vs. 15.0(7.0, 40.0)mm 1 h] and serum amyloid A protein (SAA)[69.69(4.70, 200.02)mg/L vs. 19.68(2.13, 144.48)mg/L] (P<0.05). Among 499 bronchoalveolar lavage results, there were 296 cases of general infection, 127 cases of tuberculosis, 44 cases of malignant tumors, and 32 cases of non-infectious diseases. ROC curve analysis indicated that hs-CRP and white blood cell count had high diagnostic value in positive patients. Analysis of BALF-positive patients with different disease entities revealed that inflammatory markers in tuberculosis and general infection were significantly higher than those in negative patients.

Conclusion

There is a significant difference between bronchoscopy findings and clinical diagnosis, and alterations in inflammatory markers in BALF vary among different respiratory diseases. This suggests that inflammatory markers in BALF may help improve the interpretation of bronchoscopy results and hold clinical significance for the early diagnosis of pulmonary diseases.

Key words: Respiratory diseases, Effectiveness of bronchoscopy, Bronchoalveolar lavage fluid, Retrospective study

Tiantian Ma, Hongjun Zhang, Wenhao Zheng, Xing Gu, Mingqi Wang. A analysis on the consistency between bronchoscopy results and clinical diagnosis: A retrospective study of 936 patients[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2026, 19(02): 297-302.

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Figures/Tables 6

References 20

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	最后诊断		合计	χ²值	P值
	符合	不符合	合计	χ²值	P值
支气管镜检查				306.331	0.001
＋	476	7	483
－	220	233	453
合　计	696	240	936

	最后诊断		合计	χ²值	P值
	符合	不符合	合计	χ²值	P值
支气管镜检查				306.331	0.001
＋	476	7	483
－	220	233	453
合　计	696	240	936

临床资料	阳性组	阴性组	χ²/Z值	P值
性别(例)　男/女	289/151	172/92	0.021	0.886
年龄(例)			2.076	0.15
<60岁	217	145
≥60岁	223	119
hs-CRP[M(Q₁，Q₃)，mg/L]	12.28(2.77，83.49)	7.22(1.00，52.37)	2.866	0.004
白细胞×10⁹/L	9.33±6.03	7.88±3.49	12.482	0.001
淋巴细胞×10⁹/L	1.14±0.63	1.37±0.60	23.286	0.001
血沉[M(Q₁，Q_s3)，mm 1 h]	31.0(9.0，70.5)	15.0(7.0，40.0)	4.641	0.001
SAA[M(Q₁，Q₃)，mg/L]	69.69(4.70，200.02)	19.68(2.13，144.48)	3.014	0.003

临床资料	阳性组	阴性组	χ²/Z值	P值
性别(例)　男/女	289/151	172/92	0.021	0.886
年龄(例)			2.076	0.15
<60岁	217	145
≥60岁	223	119
hs-CRP[M(Q₁，Q₃)，mg/L]	12.28(2.77，83.49)	7.22(1.00，52.37)	2.866	0.004
白细胞×10⁹/L	9.33±6.03	7.88±3.49	12.482	0.001
淋巴细胞×10⁹/L	1.14±0.63	1.37±0.60	23.286	0.001
血沉[M(Q₁，Q_s3)，mm 1 h]	31.0(9.0，70.5)	15.0(7.0，40.0)	4.641	0.001
SAA[M(Q₁，Q₃)，mg/L]	69.69(4.70，200.02)	19.68(2.13，144.48)	3.014	0.003

临床指标	NGS阳性(n＝190)	NGS阴性(n＝250)	χ²/Z值	P值
性别(例)　男/女	125/65	164/86	0.002	0.967
年龄(例)			0.018	0.892
<60岁	93	124
≥60岁	97	126
hs-CRP[M(Q₁，Q₃)，mg/L]	30.65(3.70，82.86)	10.33(2.47，82.26)	1.485	0.138
白细胞×10⁹/L	10.09±7.28	8.74±4.80	5.343	0.021
淋巴细胞×10⁹/L	1.15±0.62	1.13±0.63	0.139	0.709
血沉[M(Q₁，Q₃), mm 1 h]	33.0(11.0，70.0)	30.0(9.0，71.5)	0.85	0.395
SAA[M(Q₁，Q₃), mg 1 h]	95.66(6.58，209.83)	48.28(3.01，186.86)	1.953	0.051

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