快速现场评价联合支气管内超声引导下经支气管镜肺活检对肺外周恶性肿瘤的诊断价值  

Diagnostic value of rapid on⁃site evaluation combined with EBUS⁃TBLB for peripheral pulmonary malignant diseases

作　　者：鲁沈源[1] 唐纯丽[2] 陈愉[2] 陈小波[2] 钟长镐[2] 耿榕梅 LU Shenyuan;TANG Chuni;CHEN Yu;CHEN Xiaobo;ZHONG Changhao;GENG Rongmei(Department of Pulmonary and Critical Care Medicine,Longgang District People's Hospital of Shenzhen,The Second Affiliated Hospital of the Chinese University of Hongkong(Shenzhen),Shenzhen 518172,Guangdong,China;Department of Pulmonary and Critical Care Medicine,The First Affiliated Hospital of Guangzhou Medical University,National Center for Respiratory Medicine,National Clinical Research Center for Respiratory Disease,State Key Laboratory of Respiratory Disease,Guangzhou Institute of Respiratory Health,Guangzhou 510163,Guangdong,China)

机构地区：[1]深圳市龙岗区人民医院香港中文大学(深圳)附属第二医院呼吸与危重症医学科,广东深圳518172 [2]广州医科大学附属第一医院呼吸与危重症医学科国家呼吸医学中心国家呼吸系统疾病临床医学研究中心呼吸疾病国家重点实验室广州呼吸健康研究院,广东广州510163

出　　处：《广州医科大学学报》2024年第3期31-36,共6页Academic Journal of Guangzhou Medical University

摘　　要：目的:探讨快速现场评价(ROSE)联合支气管内超声引导下经支气管镜肺活检(EBUS-TBLB)在诊断肺外周恶性肿瘤中的临床价值。方法:回顾性分析2021年1月至2022年6月在广州医科大学附属第一医院国家呼吸医学中心行EBUS-TBLB检查的肺外周病灶直径≤30 mm的患者190例,根据是否进行ROSE检查,分为ROSE组(50例)和非ROSE组(140例),比较两组的总体诊断率,并分析病灶所在肺叶位置、病灶直径、超声探头在病灶中的位置以及病灶距胸膜的距离等因素对两组患者诊断率的影响。结果:ROSE联合EBUS-TBLB可提高肺外周恶性肿瘤的诊断率(84.00%比60.71%,P=0.003)。在直径21~30 mm的病灶中,ROSE组的诊断率显著高于非ROSE组(85.29%比64.13%,P=0.022)。ROSE可明显提高超声图像显示病变包绕超声探头的肿瘤病灶的诊断率(90.32%比62.34%,P=0.004)。在距离胸膜≤15 mm的病灶中,ROSE组的诊断率明显高于非ROSE组(95.24%比60.76%,P=0.003)。结论:ROSE可显著提高EBUS-TBLB对肺外周恶性肿瘤的诊断率,在直径21~30 mm、超声影像中间型以及距离胸膜≤15mm的病灶中有更明显的优势。Objective:To explore the diagnostic value of rapid on-site evaluation(ROSE)combined with endobronchial ultrasound transbronchial lung biopsy(EBUS-TBLB)for peripheral pulmonary malignant diseases.Methods:A retrospective analysis was performed on 190 patients with peripheral pulmonary lesions≤30 mm in diameter who underwent EBUS-TBLB examination in the National Center for Respiratory Medicine,the First Affiliated Hospital of Guangzhou Medical University from January 2021 to June 2022.According to whether ROSE examination was performed,they were divided into ROSE group(50 cases)and non-ROSE group(140 cases).The overall diagnostic rate of the two groups was compared,and the effects of the location of the lung lobe,the diameter of the lesion,the position of the ultrasonic probe in the lesion and the distance from the lesion to the pleura on the diagnostic rate of the two groups were analyzed.Results:ROSE combined with EBUS-TBLB can improve the diagnostic rate of peripheral lung malignant tumors(84.00%vs 60.71%,P=0.003).In lesions with a diameter of 21-30 mm,the diagnostic rate of ROSE group was significantly higher than that of non-ROSE group(85.29%vs 64.13%,P=0.022).ROSE could significantly improve the diagnostic rate of tumor lesions surrounded by ultrasound probe(90.32%vs 62.34%,P=0.004).The diagnostic rate of ROSE group was significantly higher than that of non-ROSE group in lesions≤15 mm from the pleura(95.24%vs 60.76%,P=0.003).Conclusion:ROSE can significantly improve the diagnostic rate of EBUS-TBLB for peripheral malignant tumors of the lung,and has more obvious advantages in lesions with a diameter of 21-30 mm,intermediate type of ultrasound image,and a distance from the pleura≤15 mm.

关 键 词：快速现场评价 支气管内超声 经支气管镜肺活检 肺外周肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]