文章：

CT引导与导航支气管镜活检对孤立性肺结节的比较：一项单中心回顾性研究

CT-Guided vs. Navigational Bronchoscopic Biopsies for Solitary Pulmonary Nodules: A Single-Institution Retrospective Comparison

原文发布日期：2 November 2023

DOI: 10.3390/cancers15215258

类型: Article

开放获取: 是

英文摘要：

Objective: Lung cancer is the second most common cause of death by cancer. Multiple modalities can be used to obtain a tissue sample from a pulmonary nodule. We aimed to compare the yield and adverse events related to transthoracic needle aspiration (TTNA) and Electromagnetic Navigation Biopsy (ENB) at our institution. Methods: This was a single-center retrospective study in which all patients referred for evaluation of a pulmonary lesion over 5 years (1 January 2013 to 31 December 2018) were identified. Our primary outcome was to compare the accuracy of TTNA to that of ENB in establishing the diagnosis of pulmonary lesions. Secondary outcomes included the evaluation of the adverse events and the sensitivity, specificity, positive, and negative predictive value of each modality. Results: A total of 1006 patients were analyzed. The mean age of patients in the TTNA and the ENB group was 67.2 ± 11.2 years and 68.3 ± 9.2 years respectively. Local anesthesia was predominantly used for TTNA and moderate sedation was more commonly used in the ENB group. We found ENB to have an accuracy of 57.1%, with a sensitivity of 40.0%, a specificity of 100.0%, a positive predictive value of 100.0%, and a negative predictive value of 40.0%. As for the TTNA, the accuracy was 75.9%, with a sensitivity of 77.5%, a specificity of 61.5%, a positive predictive value of 95.0%, and a negative predictive value of 22.5%. The rate of clinically significant complications was higher in the TTNA group (8.2%) as compared to the ENB group (4.7%) with ap-value < 0.001. Conclusion: TTNA was superior to ENB-guided biopsy for the diagnostic evaluation of lung nodules. However, the complication rate was much higher in the TTNA group as compared to the ENB group.

摘要翻译： 

目的：肺癌是癌症致死的第二大常见原因。获取肺结节组织样本可采用多种方式。本研究旨在比较本机构经胸壁穿刺抽吸术与电磁导航活检术的诊断效能及相关不良事件。方法：本单中心回顾性研究纳入2013年1月1日至2018年12月31日期间所有因肺部病变接受评估的患者。主要结局指标为比较TTNA与ENB在肺部病变诊断中的准确性。次要结局指标包括评估两种技术的不良事件发生率及其敏感性、特异性、阳性预测值和阴性预测值。结果：共纳入1006例患者进行分析。TTNA组与ENB组患者平均年龄分别为67.2±11.2岁和68.3±9.2岁。TTNA主要采用局部麻醉，ENB组则更常使用中度镇静。研究发现ENB诊断准确率为57.1%，敏感性40.0%，特异性100.0%，阳性预测值100.0%，阴性预测值40.0%。而TTNA诊断准确率为75.9%，敏感性77.5%，特异性61.5%，阳性预测值95.0%，阴性预测值22.5%。TTNA组具有临床意义的并发症发生率（8.2%）显著高于ENB组（4.7%），p值<0.001。结论：在肺结节的诊断评估中，TTNA的诊断效能优于ENB引导活检，但其并发症发生率显著高于ENB组。

原文链接：

CT-Guided vs. Navigational Bronchoscopic Biopsies for Solitary Pulmonary Nodules: A Single-Institution Retrospective Comparison