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BackgroundTransbronchial lung biopsy (TBLB) of peripheral pulmonary lesions (PPLs) is usually performed for a definite diagnosis. Radial probe endobronchial ultrasonography is often acknowledged as a good guidance method for TBLB as it can help physicians confirm the lesions’ position. It is also a non-invasive imaging diagnostic method. This clinical study was designed to evaluate the ability of radial endobronchial ultrasonography (R-EBUS) to differentiate benign from malignant predominant solid PPLs based on imaging features.MethodsPatients with predominant solid PPLs were enrolled in this study retrospectively. TBLB was performed using R-EBUS with or without other guidance techniques. One typical sonographic image and one video of each lesion were recorded for analysis. Six radial probe endobronchial ultrasonographic image features (size, shape, echogenicity, margin, blood vessel, and linear-discrete air bronchogram) were studied by ultrasonography specialists and physicians who were blinded to the final diagnosis. The sum score model of the combined predictive factors indicated the best diagnostic accuracies for predicting malignant PPLs. The model group results were used to establish the diagnostic standard for a verification group.ResultsA total of 303 patients were enrolled in the model group from July 2018 to July 2019 at the Shanghai Chest Hospital (214 with malignant and 89 with benign lesions). The mean lesion long axis on computed tomographic images was 34.39±13.79 mm. There were significant statistical differences between benign and malignant lesions in the long axis, short axis, shape, margin, blood vessel, and linear-discrete air bronchogram assessed by radial endobronchial ultrasound. Long axis, lobulation, distinct but not sharp margin, absence of blood vessel, and absence of linear-discrete air bronchogram were good predictive factors of malignant lesions. A sum score model value of 79.54% of these combined factors indicated the best diagnostic accuracy for predicting malignant lesions. Eighty-seven patients were enrolled in the verification group from August to October 2019. The sum score model showed a diagnostic accuracy of 82.76%.ConclusionsRadial endobronchial ultrasonographic features can differentiate malignant from benign lesions and thus have potential diagnosis value in predominant solid PPLs.  相似文献   
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目的:探讨心理干预与纤维支气管镜肺活检并发症的相关性。方法:将400例纤支镜肺活检病人随机分为对照组和实验组各200例,在常规护理基础上实验组对行支气管肺活检病人强化心理护理以预防并发症的发生。结果:并发症发生率实验组(1%)较对照组(3.5%)明显降低,两组比较,差别有显著性意义。结论:对纤支镜肺活检病人实施积极的心理干预,并发症发生率明显降低,有利于机体康复。  相似文献   
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Transbronchial lung cryobiopsy (TBLC) is a useful and safe method for the diagnosis of interstitial lung disease (ILD). Herein, we describe the cases of two patients who developed ILD from anti-aminoacyl-tRNA synthetase syndrome with respiratory failure. TBLC was performed instead of surgical lung biopsy. There were no complications, and sufficient specimens were harvested to make the precise histopathological diagnosis. TBLC should be considered as a critical approach for the histopathological diagnosis of ILD in patients who cannot undergo surgical lung biopsy because of respiratory failure.  相似文献   
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无基础疾病的肺隐球菌性病临床分析   总被引:1,自引:0,他引:1  
目的探讨无基础疾病的原发性肺隐球菌病(PC)临床特点。影像学表现及临床常用的确诊方法。方法回顾2006年至今我科确诊的无基础疾病的肺隐球菌性病10例对其临床资料及、影像学特点及确诊方法进行分析及研究。结果10例病人均青壮年,无基础疾病,男性7例,女性3例,其中1例为体检发现,其余9例仅有轻微的咳嗽、咳痰症状,体格检查均无异常发现,影像学表现为:肺结节肿、块型、肺炎型其中1例有空洞形成,2例可见“晕轮征”。8例通过经皮肺穿刺活检确诊的,2例行隐球菌乳胶凝集试验阳性诊断。8例病人给以氟康唑治疗,2例给以伊曲康唑治疗病灶均明显吸收。结论原发性肺隐球菌病临床表现缺乏特异性,随着近年来发病率的增高,特别是无基础疾病的人群中应提高诊断意识,避免误诊,并应积极开展经皮肺穿刺活检及TBLB检查,避免开胸活检。  相似文献   
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本文报告231例肺外周局限性结节和片状浸润病变和弥漫性病变在X线指导下TBLB的检查结果,总的诊断率78.8%,肺外周病变诊断丰79.1%,肺弥漫性病变诊断率78.2%。影响TBLB诊断率的因素与病变大小、部位、性质和活检技术有关.在提高诊断方面,活检钳、毛刷、活检针检查有相互补充作用.TBLB并发症少,本组有15例(6.4%)出现少量出血。  相似文献   
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BACKGROUND: Somatic mutations of epidermal growth factor receptor (EGFR) are closely associated with an objective response to EGFR tyrosine kinase inhibitors. However, it is difficult to obtain sufficient tumor samples from patients with non-small cell lung cancer (NSCLC), so these diagnoses are often made using cytology procedures alone. The aim of this study was to detect EGFR mutations in transbronchial needle aspiration (TBNA) samples using both direct sequencing and a highly sensitive assay (Scorpions Amplified Refractory Mutation System; DxS; Manchester, UK) [ARMS], and to compare the sensitivity of these methods. METHODS: We enrolled 94 patients (63 men and 31 women) with NSCLC in this study. Cytologic diagnoses were adenocarcinoma (n = 58), squamous cell carcinoma (n = 24), and other types of NSCLC (n = 12). We extracted DNA from the TBNA samples, and EGFR mutations were analyzed using both direct sequencing (exons 19 and 21) and the Scorpions ARMS method (E746 A750del and L858R). RESULTS: Mutations were detected in 31 patients (33%; 14 women and 17 men). Of these, 23 patients had adenocarcinoma, 4 had squamous cell carcinoma, and 4 had other types of NSCLC. Direct sequencing detected 13 mutations (14%) in 13 patients (E746-A750del, n = 6; L858R, n = 7), and the Scorpions ARMS method detected 27 mutations (29%) in 27 patients (E746 A750del, n = 16; L858R, n = 11 patients). CONCLUSIONS: Both methods detected EGFR mutations in TBNA samples, but Scorpions ARMS is more sensitive than direct sequencing.  相似文献   
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魏霞  李洁  崔亚娟 《临床肺科杂志》2011,16(8):1235-1236
目的重视提高周围型小结节肺癌的早期诊断。方法回顾分析28例纤支镜检阴性的周围性小结节肺癌临床特点,分析确诊的方法。结果 28例肺活检阴性的肺外周小结节肺癌,经手术确诊12例,CT引导下经皮肺穿刺确诊10例,胸水及心包积液脱落细胞确诊4例,淋巴结活检确诊2例。开胸手术及经皮肺活检确诊病例占78%。组织学类型:腺癌16例,鳞癌10例,小细胞未分化癌2例,腺癌比例占57%。血CEA升高者6例,均高于正常5倍以上。结论经纤支镜肺活检阴性的肺外周小结节病变,应重视通过手术或经皮肺活检获得病理诊断,提高小结节肺癌早期诊断率。血、胸水、肺泡灌洗液CEA的检测有助肺癌的诊断。  相似文献   
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目的探讨CT引导下经纤维支气管镜肺活检(TBLB)对肺孤立结节诊断的应用价值。方法对60例肺孤立结节病例随机分为CT引导下TBLB组和CT引导下经皮肺穿刺活检组,分别统计两组病例在活检阳性率及并发症发生率方面是否有差异。结果在所有病例中,CT引导下TBLB阳性率为83.3%,CT引导下经皮肺穿刺活检阳性率为76.6%,两者差异无统计学意义伊〉0.051但对病灶距离胸膜面大于3cm者,CT引导下TBLB阳性率为93.8%,经皮肺穿刺活检阳性率为64.7%,两者差异有统计学意义(P〈0.05)。CT引导下TBLB气胸发生率为3.3%,CT引导下经皮肺穿刺活检气胸发生率为30%,两者差异有高度统计学意义(P〈0.01)CT引导下TBLB出血发生率为13.3%,CT引导下经皮肺穿刺活检出血发生率为20%,两者差异无统计学意义垆〉0.05)。结论CT引导下TBLB可应用于肺孤立结节的诊断,特别是对于病灶距离胸膜面大于3cm者,该技术可靠安全,值得在临床推广应用。  相似文献   
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