CT引导和VBN辅助EBUS-GS与周围型肺癌疾病诊断效果的关系研究  

Evaluation of EBUS-GS with CT-guided and VBN-assisted in the diagnosis of peripheral lung cancer

作　　者：米玉霞 耿云平[1] 苏慧东[1] 王雯[1] MI Yu-xia;GENG Yun-ping;SUHui-dong;WANG Wen(Nanyang Center Hospital,Nanyang Henan 473000,China)

机构地区：[1]南阳市中心医院,河南南阳473000

出　　处：《中国临床医学影像杂志》2023年第2期105-108,共4页Journal of China Clinic Medical Imaging

基　　金：河南省医学科技攻关计划项目(编号:2018020940)。

摘　　要：目的:分析CT引导和虚拟导航支气管镜(Virtual navigation bronchoscope,VBN)辅助导向鞘引导的超声支气管镜(Endobronchial ultrasound with guide-sheath,EBUS-GS)与周围型肺癌诊断效果,为临床应用提供依据。方法:选择我院2019年12月—2021年4月收治的106例周围型肺癌患者:按所行操作方法分为3组:超声引导(n=36)、CT引导(n=36)、CT引导联合VBN辅助EBUS-GS(n=34);以术后病理学检测结果为金标准,绘制ROC曲线分析各方法取样检测诊断的诊断价值。结果:采用CT联合VBN辅助EBUS-GS探查病变内部率明显高于超声引导和CT引导,且差异存在统计学意义(P<0.05);以超声引导探查诊断为周围型肺癌的阳性率为66.7%,以CT引导探查诊断为周围型肺癌的阳性率为72.2%,以CT联合VBN辅助EBUS-GS探查诊断为周围型肺癌的阳性率为82.4%。CT引导VBN辅助EBUS-GS诊断周围型肺癌的敏感度、特异度和AUC均明显高于超声引导和CT引导,且差异存在统计学意义(P<0.05)。结论:CT引导VBN辅助EBUS-GS可显著提高周围型肺癌的诊断效能。Objective: To analyze the effeciency of CT-guided and virtual navigation bronchoscope(VBN)-assisted diagnosis of endobronchial ultrasound with guide-sheath(EBUS-GS) in the diagnosis of peripheral lung cancer, providing a basis for clinical application. Methods: 106 patients with peripheral lung cancer in our hospital from December 2019 to April 2021 were included. They were divided into three groups: CT guided percutaneous lung puncture group(n =36), ultrasound-guided percutaneous lung puncture group(n=36) and EBUS-GS group(n=34);with postoperative pathological test results as the gold standard, the ROC curve was drawn to analyze the diagnostic value of sampling, detection and diagnosis of each method. Results: The cancer detecting rate of EBUS-GS with CT-guided and VBN-assisted was significantly higher than that with ultrasound-guided and CT-guided, and the difference was statistically significant(P<0.05). The positive rate of peripheral lung cancer diagnosed by ultrasound-guided EBUS was 66.7%. The positive rate of peripheral lung cancer diagnosed by CT-guided EBUS was 72.2%. The positive rate of peripheral lung cancer diagnosed with CT-guidance and VBN-assisted EBUS-GS was 82.4%. The sensitivity, degree, specificity and AUC of CT-guided VBN-assisted EBUS-GS in the diagnosis of peripheral lung cancer were significantly higher than those of ultrasound-guided and CT-guided, and the difference was statistically significant(P<0.05). Conclusion: CT-guided and VBN-assisted EBUS-GS can significantly improve the diagnostic efficiency of peripheral lung cancer.

关 键 词：肺肿瘤 支气管镜检查 体层摄影术 螺旋计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学] R768.1