Diagnostic value of thin-slice CT navigation combined with cytology in preoperative bronchoscopy of peripheral pulmonary lesions
10.3760/cma.j.issn.0253-3766.2019.02.002
- VernacularTitle: 薄层CT导航联合细胞学在周围型肺癌术前常规支气管镜检查中的价值
- Author:
Lei ZHANG
1
;
Ting GAO
2
;
Xiaoduo YU
1
;
Shun HE
1
;
Huaying XUN
1
;
Guiqi WANG
1
Author Information
1. Dapartmnet of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
2. Department of Respiration and Critical Care Medicine, Xianyang Central Hospital, Xianyang 712000, China
- Publication Type:Journal Article
- Keywords:
Thin-slice computed tomography;
Peripheral lung carcinoma;
Bronchoscopy;
Cytology;
Bronchoalveolar lavage
- From:
Chinese Journal of Oncology
2019;41(2):86-90
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the diagnostic value of thin-slice CT navigation combined with cytology in routine preoperative bronchoscopy of peripheral pulmonary lesions and compare the diagnostic effects of different cytological sampling methods.
Methods:The clinical data of peripheral lung cancer patients with preoperative bronchoscopy and cytology sampling guided by thin-slice CT from May 2015 to July 2016 in Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. The diagnostic accuracy, sensitivity and specificity of different cytological sampling methods for peripheral pulmonary lesions guided by thin-slice CT were compared, the factors affected the diagnostic sensitivity were analyzed, and the complications induced by these methods were observed.
Results:The diagnostic sensitivity of thin-slice CT navigation combined with bronchoalveolar lavage for peripheral pulmonary lesions was 39.1%, and the positive diagnosis rate was 35.1%. The diagnostic sensitivity of thin-slice CT navigation combined with cell brush for peripheral pulmonary lesions was 51.7%, and the positive diagnosis rate was 46.4%. The diagnostic sensitivity of bronchoalveolar lavage combined with cell brush for peripheral pulmonary lesions was 57.5%, and the positive diagnosis rate was 51.5%. The positive diagnosis rate between brush sampling and bronchoalveolar lavage was statistically different (P=0.01). No significant difference was observed in the diagnostic rate between cell brush and cell brush combined with bronchoalveolar lavage (P=0.06). The factors affected diagnostic sensitivity of brush included the lesion location, size, and the relationship between the lesion and bronchial (all P<0.05). When the size of the peripheral lung lesion >2 cm, the diagnostic sensitivity of thin-slice CT navigation combined with cell brush for peripheral pulmonary lesions was 73.6%. Its positive diagnosis rate was 68% and the specificity was 100%, respectively. Two cases of mild bleeding were observed, and hemorrhage was terminated by conservative treatment.
Conclusion:Preoperative thin-slice CT navigation combined with cytological examination is an effective method for the diagnosis of peripheral pulmonary lesions, and the diagnostic efficiency of cell brush is higher than that of bronchoalveolar lavage, especially for the lesion size >2 cm.
