径向超声支气管镜联合快速现场评估在细菌学阴性肺结核诊断中的应用

目的 评估径向超声支气管镜活检(EBUS-GS-TBLB)联合快速现场评估(ROSE)对细菌学阴性肺结核诊断的价值.方法 根据临床症状、影像学图像、痰细菌学结果(痰涂片和结核分枝杆菌培养)及首次分子生物学检查结果,收集2020年1月-12月疑似肺结核患者70例,随机分入A组(EBUS-GS-TBLB)34例和B组(EB...

Application of endobronchial ultrasound transbronchial lung biopsy with guide sheath and rapid on-site evaluation in the diagnosis of bacteriologically-negative pulmonary tuberculosis

Objective To evaluate the combination of endobronchial ultrasonography with guide sheath (EBUS-GS), transbronchial lung biopsy (TBLB), and rapid on-site evaluation (ROSE) for the diagnosis of bacteriologically-negative pulmonary tuberculosis (PTB).Methods A total of 70 patients with suspected PTB were enrolled from January 2020 to December 2020 based on clinical symptoms, abnormal radiographic findings, sputum bacteriological examination (smear and culture), and initial sputum molecular detection negative results. The patients randomly divided into two groups: group A underwent EBUS-GS-TBLB (n=34), and group B underwent EBUS-GS-TBLB+ROSE (n=36). The diagnostic rates and biopsy numbers were evaluated between the two groups.Results 16 patients with PTB were detected in group A, and 22 in group B. After the joint ROSE, The PTB diagnostic rate improved from 47.06% to 61.11%(P=0.238), and the mean numbers of biopsy decreased from 4.53±0.50 to 3.08±0.60(P<0.01). The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of ROSE for the diagnosis of PTB were 86.36%, 86.67%, 85.71%, 92.86%, and 75.00%, respectively, with no serious complications.Conclusion The combination of EBUS-GS-TBLB and ROSE can improve the diagnostic rate, and reduce the biopsy numbers, which is thought of an effective and safe novel diagnostic modality.