快速现场评估(ROSE)在胸部肿瘤气管镜介入诊断中的应用价值  

The value of rapid on-site evaluation applied in the bronchoscopic intervention for diagnosis of thoracic neoplasms

作　　者：王丽伟[1] 李银 万良红 黄云超[3] 谭慧[3] 胡早秀[4] 黄秋博 田民 Wang Liwei;Li Yin;Wan Lianghong;Huang Yunchao;Tan Hui;Hu Zaoxiu;Huang Qiubo;Tian Min(Department of Ultrasound Medicine,the Third Affiliated Hospital of Kunming Medical University(Yunnan Cancer Hospital,Yunnan Cancer Center),Yunnan Kunming 650118;Thoracic Surgery and Tumor Department,Fuyuan County People's Hospital(the Third Affiliated Hospital of Kunming Medical University Union Hospital),Yunnan Qujing 655000;Department of Thoracic Surgery I,the Third Affiliated Hospital of Kunming Medical University(Yunnan Cancer Hospital,Yunnan Cancer Center),Yunnan Kunming 650118;Pathology Department,the Third Affiliated Hospital of Kunming Medical University(Yunnan Cancer Hospital,Yunnan Cancer Center),Yunnan Kunming 650118;Department of Vascular Surgery,Yanan Hospital of Kunming City,Yunnan Kunming 650051,China)

机构地区：[1]昆明医科大学第三附属医院(云南省肿瘤医院)超声医学科,云南昆明650118 [2]富源县人民医院(昆明医科大学第三附属医院联盟医院)胸外(肿瘤)科,云南曲靖655500 [3]昆明医科大学第三附属医院(云南省肿瘤医院)胸外科一病区,云南昆明650118 [4]昆明医科大学第三附属医院(云南省肿瘤医院)病理科,云南昆明650118 [5]昆明市延安医院血管外科,云南昆明650051

出　　处：《中华介入放射学电子杂志》2021年第3期307-312,共6页Chinese Journal of Interventional Radiology：electronic edition

摘　　要：目的探讨快速现场评估(ROSE)在胸部肿瘤支气管活检中的应用价值及安全性分析。方法回顾性分析云南省肿瘤医院2019年10月—2020年10月间635例行支气管内镜检查联合快速现场评估胸部肿瘤患者的临床资料,全组患者均为CT或PET/CT确认存在肺部占位性病变、至少1组纵隔或肺门淋巴结肿大。结果全组患者均顺利完成活检操作,并发症发生率14.9%(95/635),无严重并发症;全组ROSE诊断与HE染色诊断一致性93.7%(594/635),确诊恶性485例中,ROSE诊断假阴性率2.4%(15/635),未出现假阳性结果;全组肺肿物共取材680部位,共1785次取材,平均取材数(2.6±1.9)次,取材成功率89.3%(1588/1785);纵隔淋巴结穿刺435处,共865针,平均穿刺数(2.0±0.4)次,穿刺成功率82.1%(710/865)。70例首次非ROSE检查HE结果为可疑恶性患者,行ROSE检查评估最终11例确诊为恶性,有效率78.5%(55/70)。结论快速现场评估技术运用于胸部肿瘤支气管活检诊断,取材成功率高、与HE染色一致性好,可有效降低二次检查率,操作简便、安全可靠、值得临床推广。Objective To explored the value and safety of rapid on-site evaluation(ROSE)applied in bronchoscopic intervention for diagnosis of thoracic neoplasms.Methods The clinical data of 635 patients with thoracic neoplasms underwent bronchoscopic intervention diagnosis and ROSE in the Yunnan Tumor Hospital from October 2019 to October 2020 were retrospectively analyzed.All patients were confirmed by CT or PET/CT with pulmonary lesions or at least 1 set of mediastinal or hilar lymph nodes enlargement.Results All patients successfully completed the biopsy operation.The complication rates were 14.9%(96/635),and there were no serious complications.The coherence of ROSE and HE staining was 93.7%(594/635).Among 485 cases of malignant diagnosis,the false negative rate of ROSE was 2.4%(15/635),and there were no false positive results.The whole group of lung neoplasms were performed 1785 times biopsies at 680 sites,with an average of(2.6±1.9)per site.The successful rate of biopsies was 89.3%(319/357).Mediastinal lymph nodes were punctured at 435 sites for 865 times with an average of(2.0±0.4)punctures per site.The successful rate was 82.1%(710/865).Among 70 patients with suspected malignant by HE staining in the first non-ROSE examination,55 cases got confirmed malignant diagnoses by ROSE examination,and the effective rate was 78.5%(55/70).Conclusions ROSE applied in the bronchoscopic intervention for diagnosis of thoracic neoplasms has good concordance with HE staining in the diagnosis.ROSE has a high biopsy success rate,could effectively reduce the recheck rate,and is easy to operate,safe and reliable.ROSE is worthy of clinical application.

关 键 词：快速现场评估 胸部肿瘤 气管镜介入诊断 

分 类 号：R734[医药卫生—肿瘤]