JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (4): 34-38.doi: 10.6040/j.issn.1671-7554.0.2016.1005

Previous Articles     Next Articles

Endobronchial ultrasound transbronchial lung biopsy with guide-sheath for the diagnosis of pulmonary peripheral lesions

ZHANG Huanan1, WANG Chaochao1, ZHANG Yuan2, XU Shaohua1, WANG Ying1, WANG Wei1   

  1. 1. Department of Respiratory Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong, China;
    2. Center of Evidence-Based Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Received:2016-08-17 Online:2017-04-10 Published:2017-04-10

PDF (PC)

155

Abstract: Objective To evaluate the diagnostic value and safety of endobronchial ultrasound transbronchial lung biopsy with guide-sheath(EBUS-GS-TBLB)in peripheral pulmonary lesions(PPL), and to investigate the related factors of improving EBUS-GS-TBLB diagnostic rate. Methods A total of 67 patients with suspected PPL who underwent transbronchial lung biopsy in the Department of Respiratory Medicine of the Second Hospital of Shandong University between January 2015 and March 2016 were prospectively evaluated. The patients were divided into the conventional group(n=38)and the endobronchial ultrasound group with guide sheath group(EBUS-GS group, n=29). The diagnostic rate and the related factors were analyzed. Results There was no significant difference in gender, age and lesion size of the two groups(P>0.05). The diagnostic rate of the EBUS-GS group was 75.9%(22/29), which was higher than that of the conventional group, 47.4%(18/38),(χ2=5.55, P=0.018). In EBUS-GS group, the diagnostic rate of the lesion diameter >2 cm was 94.1%(16/17), while the lesion diameter ≤2 cm was 50.0%(6/12). The difference was statistically significant(P=0.011). The diagnostic rate of EBUS probe within the lesions was 89.4%(17/19), while probe outside the lesions was 50.0%(5/10). The difference was statistically significant(P=0.030). There was no correlation between the diagnostic rate and the location of the lesions(P>0.05)in EBUS-GS- 山 东 大 学 学 报 (医 学 版)55卷4期 -张华楠,等.支气管超声下经引导鞘肺活检术诊断肺周围性疾病的价值 \=-TBLB. Conclusion The procedure of EBUS-GS-TBLB is minimally invasive, has higher diagnostic rate and fewer complications, so it is a safe and effective method to diagnose PPL. The diagnostic rate of EBUS-GS-TBLB is related to both the lesion size and ultrasonic probe position.

Key words: Bronchoscopy, Peripheral pulmonary lesions, Uhrasonography interventional, Biopsy

CLC Number: 

  • R574
[1] Kanne JP. Screening for lung cancer:what have we learned?[J]. AJR Am J Roentgenol, 2014, 202(3): 530-535.
[2] 中华医学会呼吸病学分会肺癌学组,中国肺癌防治联盟专家组.肺部结节诊治中国专家共识[J].中华结核和呼吸杂志, 2015, 38(4): 249-254.
[3] Wongsurakiat P, Wongbunnate S, Dejsomritrutai W, et al. Diagnostic value of bronchoalveolar lavage and postbronchoscopic sputum cytology in peripheral lung cancer[J]. Respirology, 1998, 3(2): 131-137.
[4] Tang CC, Hsiao CJ, Chen H, et al. Value of bronchoalveolar Lavage combined with transbronchial lung biopsy in the diagnosis of peripheral lung cancer[J]. Chang Gung Med J, 2000, 23(11): 695-700.
[5] Baaklini WA, Reinoso MA, Gorin AB, et al. Diagnostic yield of fiberoptic bronchoscopy inevaluating solitary pulmonary nodules[J]. Chest, 2000, 117(4): 1049-1054.
[6] Ishida T, Asano F, Yamazaki K, et al. Virtual bronchoscopic navigation combined with endobmnchial ultrasound to diagnose small pefipheral pulmonary lesions: a randomised trial[J]. Thorax, 2011, 66(12): 1072-1077.
[7] Kikuchi E, Yamazaki K, Sukoh N, et al. Endobronchial ultrasonography with guide-sheath for peripheral pulmonary lesions[J]. Eur Respir J, 2004, 24(4): 533-537.
[8] Kurimoto N, Miyazawa T, Okimasa S, et al. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically[J]. Chest, 2004, 126(3): 959-965.
[9] Manhire A, Charig M, Clelland C, et al. Guidelines for radiologically guided lung biopsy[J]. Thorax, 2003, 58(11): 920-936.
[10] Wdliamson JP, James AL, Phillips MJ, et al. Quantifying tracheobmnchial tree dimensions:methods,limitations and emerging techniques[J]. Eur Respir J, 2009, 34(1): 42-55.
[11] Shinagawa N, Nakano K, Asahina H, el al. Endobronchial ultrasonography with a guide sheath in the diagnosis of benign peripheral diseases[J]. Ann Thorae Surg, 2012, 93(3): 951-957.
[12] Herth FJ, Eberhardt R, Becker HD, et al. Endobronchial ultrasound-guided transbronchial lung biopsy in fluomscopically invisible solitary pulmonary nodules:a prospective trial[J]. Chest, 2006, 129(1): 147-150.
[13] Chao,TY, Lie CH, Chung YH, et al. Differentiating peripheral pulmonary lesions based on images of endobronchial ultrasonography[J]. Chest, 2006, 130(4): 1191-1197.
[14] Eberhardt R, Emst A, Herth FJ. Ultrasound-guided transbronchial biopsy of solitary pulmonary nodules less than 20 mm[J]. Eur RespirJ, 2009, 34(6): 1284-1287.
[15] Steinfort DP, Khor YH, Manser RL, et al. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer:systematic review and meta-analysis[J]. Eur Respir J, 201l, 37(4): 902-910.
[16] Zaric B, Stojsic V, Sarcev T, et al. Advanced bronchoscopic techniques in diagnosis and staging of lung cancer[J]. J Thorac Dis, 2013, 5(S4): S359-S370.
[17] Shinagawa N, Nakano K, Asahina H, et al. Endobronchial ultrasonography with a guide sheath in the diagnosis of benign peripheral diseases[J]. Ann Thorac Surg, 2012, 93(3): 951-957.
[18] Izumo T, Sasada S, Chavez C, et al. The diagnostic value of histology and cytology samples during endobronchial ultrasound with a guide sheath[J]. Jpn J Clin Oncol, 2015, 45(4): 362-366.
[19] Chavez C, Sasada S, Izumo T, et al. Endobronchial ultrasound with a guide sheath for small malignant pulmonary nodules: a retrospective comparison between centfal and peripheral lcations[J]. J Thorac Dis, 2015, 7(4): 596-602.
[20] 李王平,马李杰,潘蕾,等. 导向鞘引导的超声内镜在300例肺周围病变诊断中的应用分析[J].中华肺部疾病杂志(电子版), 2015, 8(5): 556-559. LI Wangping, MA Lijie, PAN Lei, et al. Analysis of diagnosis of peripheral pulmonary lesion in 300 patients with endobronchial ultrasonography-guide sheath[J]. Chin J Lung Dis(Electronic Edition), 2015, 8(5): 556-559.
[21] 唐纯丽,罗为展,钟长镐,等. 径向超声联合虚拟导航引导肺活检对肺外周结节的诊断价值[J]. 中华结核和呼吸杂志, 2016, 39(1): 38-40. TANG Chinli, LUO Weizhan, ZHONG Changhao, et al. The diagnostic utility of virtual bronchoscopic navigation combined with endobronchial ultrasound guided transbronchial lung biopsy for peripheral pulmonary lesions[J]. Chin J Tuberc Respir Dis, 2016, 39(1): 38-40.
[22] 李明,彭爱梅,张国良,等. 支气管超声下经引导鞘肺活检术诊断肺周围性病变的价值[J]. 中华结核和呼吸杂志, 2014, 37(1): 36-40. LI Ming, PENG Aimei, ZHANG Guoliang, et al. Endobronchial ultrasound transbronchial lung biopsy with guide-sheath for the diagnosis of peripheral pulmonary lesions[J]. Chin J Tuberc Respir Dis, 2014, 37(1): 36-40.
[23] 李晓,赵辉,周足力,等. 支气管超声导向鞘(EBUS-GS)引导肺活检术的临床应用[J]. 中华胸心血管外科杂志, 2015, 31(2): 104-105.
[24] Huang CT, Ho CC, Tsai YJ, et al. Factors influencing visibility and diagnostic yield of transbronchial biopsy using endobronchial ultrasound in peripheral pulmonary lesions[J]. Respirology, 2009, 14(6): 859-864.
[25] Chen A, Chenna P, Loiselle A, et al. Radial probe endobronchial ultrasound for peripheral pulmonary lesions: a 5-year institutional experience[J]. Ann Am Thorac Soc, 2014, 11(4): 578-582.
[1] LAI Guoxiang, WANG Qing. Clinical application of bronchoscopy in the airway management of patients undergoing mechanical ventilation [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 14-18.
[2] JIN Faguang. Expatiation of the diagnosis and treatment of benign central airway stenosis [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 7-13.
[3] LIU Qinghua, ZHAO Na, WANG Cheng. Misunderstanding of transbronchial needle aspiration biopsy utilization [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 30-33.
[4] WANG Chaochao, TIAN Hailong, JIANG Huifeng, GUO Wenqiang, WANG Zhigang. Clinical significance of sodium fluorescein-guided resection of high-grade glioma under “yellow fluorescence” mode [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(11): 32-37.
[5] LI Yun, ZHONG Wanxia, YAO Ning, HU Shuanggang, LIU Hongmao. Effects of female age on the outcome of preimplantation genetic diagnosis and screening [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(1): 60-62.
[6] LUAN Haihui, XU Wei, WANG Muchuan, WU Lin, WANG Lingling, MA Jun, LIU Yiming. Clinical, pathological and molecular biological study on a Chinese family of Spinocerebellar Ataxia type 6 [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(2): 63-67.
[7] YU Xiao1, YU Pi-xian2, ZHAO Dan-dan3, LIU Fu-chen3, YAN Chuan-zhu3. A3 adenosine receptor expression in idopathic
inflammatory myopathies [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(6): 105-.
[8] WANG Shasha， SHAO Yang, ZHANG Dong, WANG Lijiang, JIANG Shujuan. Trans-bronchial needle aspiration in diagnosing extra bronchial lesions [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2010, 48(1): 120-122.
[9] LI Wei,LI Dao-wei,YE Qian,GAO Shun-cui,JIANG Shu-juan.

Diagnostic value of transbronchial needle aspiration in paratracheal mediastinal lesions

[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(11): 1063-1065.
[10] SU Li-li,ZHANG Xian-xin,YI Hong-li,ZHANG Meng,LI Huai-chen. Pathological characters of the bronchial mucus membrane and inflammatory cell changes of BALF in mild and moderately persistent asthmatic patients [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(7): 692-696.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd