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Rapid on-site evaluation of touch imprints of biopsies improves the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy: a retrospective study.

活检触摸印记的快速现场评估提高了经支气管活检对内镜下不可见恶性肿瘤的诊断率: 一项回顾性研究。

  • 影响因子:0
  • DOI:10.1093/jjco/hyaa245
  • 作者列表:"Wang H","Ren T","Wang X","Wei N","Luo G","Li D","Chen Q","You H","Wang J","Wang M
  • 发表时间:2021-04-01
Abstract

OBJECTIVE:Rapid on-site evaluation has long been used for transbronchial needle aspiration or fine-needle aspiration to evaluate the adequacy of biopsy materials for the diagnosis of peripheral lung lesions. However, research on rapid on-site evaluation combined with transbronchial forceps biopsy in the diagnosis of lung carcinoma is rarely reported. Therefore, we aimed to investigate the value of rapid on-site evaluation during transbronchial forceps biopsy for endoscopically visible (tumor, infiltrative and necrotic) or nonvisible (compressive, nonspecific and normal) malignancy. METHODS:A retrospective analysis was performed between January 2015 and January 2019 in Taihe Hospital with 1216 lung cancer patients who underwent bronchoscopy procedures, and these patients were allocated into the rapid on-site evaluation group and non-rapid on-site evaluation group, depending on the timing of the procedure. According to endoscopic features, bronchoscopic appearance was described as endoscopically visible malignancy (tumor, infiltrative and necrotic) and endoscopically nonvisible malignancy (compressive, nonspecific and normal). The diagnostic yield was compared, and the concordance between the rapid on-site evaluation results and the final histology was analyzed. RESULTS:There was a statistically significant difference in the diagnostic yield between the rapid on-site evaluation and non-rapid on-site evaluation groups for endoscopically nonvisible malignancy (74.3% vs. 51.7%, P < 0.05). However, we found no significant improvement in terms of diagnostic yield for endoscopically visible malignancy (95.2% vs. 91.2%, P > 0.05). The rapid on-site evaluation results showed high-level concordance with histology in the diagnosis of squamous cell carcinoma, adenocarcinoma and small cell carcinoma, with kappa values of 0.749 (P < 0.05), 0.728 (P < 0.05) and 0.940 (P < 0.05), respectively. CONCLUSIONS:The findings demonstrated that the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy (compressive, nonspecific and normal) was significantly improved when rapid on-site evaluation was implemented. In addition, the rapid on-site evaluation results had high-level concordance with the final histological diagnosis.

摘要

目的: 长期以来,快速现场评估一直用于经支气管针吸活检或细针穿刺活检,以评估活检材料对肺周围病变诊断的充分性。然而,快速现场评估联合经支气管钳活检在肺癌诊断中的研究鲜有报道。因此,我们的目的是研究在经支气管钳活检期间快速现场评估内镜下可见 (肿瘤,浸润性和坏死性) 或不可见 (压迫性,非特异性和正常) 恶性肿瘤的价值。 方法: 回顾性分析2015年1月至2019年1月在太和医院行支气管镜检查的1216例肺癌患者,根据手术时机将这些患者分为快速现场评估组和非快速现场评估组。根据内镜特征,支气管镜外观被描述为内镜可见的恶性肿瘤 (肿瘤,浸润性和坏死性) 和内镜不可见的恶性肿瘤 (压迫性,非特异性和正常)。比较诊断率,分析快速现场评估结果与最终组织学的一致性。 结果: 快速现场评估组和非快速现场评估组对内镜下不可见恶性肿瘤的诊断率差异有统计学意义 (74.3% 对51.7%,P <0.05)。然而,我们发现内镜下可见恶性肿瘤的诊断率没有显著提高 (95.2% 对91.2%,P> 0.05)。快速现场评估结果显示,鳞癌、腺癌和小细胞癌的诊断与组织学高度一致,kappa值分别为0.749 (P < 0.05) 、0.728 (P < 0.05) 和0.940 (P <0.05)。 结论: 研究结果表明,当实施快速现场评估时,经支气管活检对内镜下不可见恶性肿瘤 (压迫性、非特异性和正常) 的诊断率显著提高。此外,快速现场评估结果与最终组织学诊断具有高度一致性。

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