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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2024年04期

页码:

524-528

栏目:

出版日期:

2024-08-25

文章信息/Info

Title:

Diagnostic value of ultrasound image features combined with virtual bronchoscopic navigation and radial endobronchial ultrasound in peripheral lung cancer

作者:

赵 静¹; 范 晔²; 游雅婷²; 陈 慧³; 王 静²; 张 静²

400037 重庆,陆军(第三)军医大学第二附属医院临床技能培训中心¹、全军呼吸内科研究所·全军呼吸病研究重点实验室²、消化内科³

Author(s):

Zhao Jing¹;  Fan Ye²;  You Yating²;  Chen Hui³;  Wang Jing²;  Zhang Jing².

¹Department of Clinical Skills Training center, Xinqiao Hospital, Army Medical University, Chongqing 400037, China; ²Department of Respiratory Disease, Xinqiao Hospital, Army Medical University, Chongqing 400037, China; ³Department of Gastroenterology Xinqiao Hospital, Army Medical University, Chongqing 400037, China

关键词:

周围型肺癌;  虚拟支气管镜导航;  径向超声支气管镜;  早期诊断

Keywords:

Peripheral lung cancer;  Virtual bronchoscopic navigation;  Radial endobronchial ultrasound;  Early diagnosis

分类号:

R734.2

DOI:

10.3877/cma.j.issn.1674-6902.2024.04.004

摘要:

目的 分析虚拟支气管镜导航(virtual bronchoscopic navigation, VBN)联合径向超声支气管镜(radial endobronchial ultrasound, R-EBUS)在周围型肺癌中的诊断意义。方法 选择2022年1月至2024年1月我院收治的行VBN+R-EBUS引导肺穿刺活检96例患者,采用χ²检验比较结节均质/非均质回声、边界特征、CT影像学诊断与组织病理诊断相关性,采用Logistic回归分析,绘制受试者工作特征曲线(receiver operating characteristic curve, ROC)曲线,分析R-EBUS超声图像特征在周围型肺癌中的诊断意义。结果 R-EBUS超声显示实性均质回声66例(68.75%),实性非均质回声30例(43.48%); 边界清楚57例(59.38%),边界欠清楚39例(40.62%)。术前经肺螺旋CT诊断为肺癌67例(69.79%),其他非肿瘤疾病29例(30.21%)。组织病理学诊断肺肿瘤58例(60.42%),其中腺癌39例(40.63%),鳞癌9例(9.38%),其他肿瘤10例(10.42%); 组织病理学诊断非肿瘤疾病38例(39.58%),其中炎症24例(25.00%),局灶肉芽肿性炎或结核6例(6.25%),其他非肿瘤疾病8例(8.33%)。均质回声及组织病理诊断为肺癌51例(53.13%)、非肺癌15例(15.63%),非均质回声组织病理学诊断为肺癌7例(7.29%),非肺癌23例(23.96%)。均质回声与肺癌组织病理诊断相关(P<0.001),回声诊断肺癌的灵敏度为87.93%,特异度为60.53%。边界欠清楚及组织病理诊断为肺癌24例(25.00%)、非肺癌34例(35.41%),边界清楚组织病理诊断为肺癌15例(15.63%),非肺癌23例(23.96%),边界特征与肺癌组织病理诊断不关联(P>0.05)。Logistic回归分析显超声回声、肺CT,以及超声回声联合肺CT三种检测方法与肺癌组织病理诊断有一致性(P<0.001),ROC曲线分析显示,超声回声AUC:0.7423,肺CT AUC:0.7945,超声回声联合肺CT AUC:0.8827。结论 R-EBUS超声图像中实性均质回声与肺癌组织病理诊断显著相关,R-EBUS联合CT影像学可提升肺癌诊断准确率。

Abstract:

Objective To evaluate the diagnostic value of virtual bronchoscopic navigation(VBN)combined with radial endobronchial ultrasound(R-EBUS)in peripheral lung cancer. Methods A total of 96 patients who underwent VBN+R-EBUS guided lung biopsy in our hospital from January 2022 to January 2024 were selected. Chi-square test was used to compare the correlation between homogeneous/heterogeneous nodule echo, boundary characteristics, CT diagnosis and pathological diagnosis. Logistic regression analysis and receiver operating characteristic curvecurve(ROC)curve were used. To investigate the diagnostic value of R-EBUS imaging features in peripheral lung cancer. Results Sixty-six cases(68.75%)showed homogeneous solid echogenicity, 30 cases(43.48%)showed heterogeneous solid echogenicity, 57 cases(59.38%)showed clear border, and 39 cases(40.62%)showed unclear border. 67 cases(69.79%)of lung cancer and 29 cases(30.21%)of other non-neoplastic diseases were diagnosed by spiral CT before operation. 58 cases(60.42%)of lung tumors were diagnosed by histopathology, including 39 cases(40.63%)of adenocarcinoma, 9 cases(9.38%)of squamous cell carcinoma and 10 cases(10.42%)of other tumors. There were 38 cases(39.58%)of non-tumor diseases diagnosed by histopathology, including 24 cases(25.00%)of inflammation, 6 cases(6.25%)of focal granulomatous inflammation or tuberculosis, and 8 cases(8.33%)of other non-tumor diseases. There were 51 cases of lung cancer(53.13%)and 15 cases of non-lung cancer(15.63%)with homogeneous echo and histopathologic diagnosis, 7 cases of lung cancer(7.29%)and 23 cases of non-lung cancer(23.96%)with heterogeneous echo.Homogeneous echo was correlated with pathological diagnosis of lung cancer(P<0.001). The sensitivity and specificity of echo diagnosis of lung cancer were 87.93% and 60.53%, respectively. Borderless and histopathologically diagnosed were lung cancer in 24 cases(25.00%)and non-lung cancer in 34 cases(35.41%). Borderless and histopathologically diagnosed were lung cancer in 15 cases(15.63%)and non-lung cancer in 23 cases(23.96%).There was no correlation between boundary features and pathological diagnosis of lung cancer(P>0.05). Logistic regression analysis showed that echo, CT and echo combined with CT detection were consistent with pathological diagnosis of lung cancer(P<0.001). ROC curve analysis showed that echo AUC:0.7423, CTAUC:0.7945, and echo combined with CTAUC:0.8827. Conclusion The solid homogeneous echo in R-EBUS image is significantly correlated with the pathological diagnosis of lung cancer. R-EBUS combined with CT can improve the diagnostic accuracy of lung cancer.

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备注/Memo

备注/Memo:

基金项目: 重庆市科卫联合医学科研项目(2023QNXM010)
通信作者: 王 静, Email: 282883495@qq.com
张 静, Email: 83728087@qq.com

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更新日期/Last Update: 2024-08-25