The clinical value of endobronchial ultrasound elastography in the diagnosis of medias-tinal and hilar lymph nodes / 中国肿瘤临床

ABSTRACT

Objective: Four ultrasound elastography parameters were used to compare the color distribution of mediastinal and hilar lymph nodes (LNs) in endobronchial ultrasound real-time elastography (EBUS-RTE), and the clinical value in differentiating benign from malignant mediastinal and hilar lymph nodes were explored. Methods: We selected patients who received EBUS-TBNA in the Second Hospital of Lanzhou University from January 2016 to December 2018 and simultaneously conducted EBUS-RTE. Elastography of lymph nodes were analyzed by elastography image type, elasticity score, strain ratio (SR), and blue color proportion (BCP), respectively. A re-ceiver operating characteristic (ROC) curve was constructed to evaluate the diagnostic value of the four ultrasound elastography pa-rameters. The area under the curve (AUC) and the critical value of the best diagnosis were calculated, and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the four parameters were compared. Results: A total of 80 pa-tients were enrolled, including 152 lymph nodes with 102 malignant lymph nodes and 50 benign ones. Elastography image type, elas-ticity score, SR, and BCP had statistical significance in the differential diagnosis of benign and malignant lymph nodes (P<0.01). The ac-curacy of BCP in the diagnosis of benign and malignant lymph nodes was the highest (88.3%), and the sensitivity, specificity, positive predictive value, and negative predictive value were 90.0%, 94.1%, 85.4%, and 88.6%, respectively. The optimal definition value of BCP was 85.7%; all the 65 LNs with a BCP≥85.7% were diagnosed as malignant. Conclusions: Elastography image type, elasticity score, SR, and BCP of ultrasound elastography are important in the differential diagnosis of mediastinal and hilar lymph nodes, and BCP showed the highest diagnostic valuation.