Value of non-real-time radial probe endobronchial ultrasound guided transbronchial lung biopsy in the diagnosis of peripheral lung cancer and analysis of false negative results / 中国内镜杂志

ABSTRACT

Objective To explore the diagnostic value of non-real-time radial probe endobronchial ultrasound (RP-EBUS) guided transbronchial lung biopsy (TBLB) for peripheral lung cancer and analysis of false negative results. Methods A retrospective analysis of the clinical and imaging data of 256 patients with peripheral lung cancer between March 2013 and December 2016, all the cases underwent non-real-time RP-EBUS guided TBLB, then evaluate its significance in the diagnosis of peripheral lung cancer and analyze the reasons of false negative results. Result In 256 patients who received non-real-time RP-EBUS examinations, 73.83% (189/256) of peripheral lung cancer were detected by RP-EBUS and the positive rate of RP-EBUS guided TBLB was 61.33% (157/256). The positive rate of non-real-time RP-EBUS guided TBLB was correlated with lesions >2 cm in diameter, lesions close to visceral pleura, ultrasonic image characteristics and the RP-EBUS probe surrounding by lesion (P < 0.05). The positive rate of non-real-time RP-EBUS guided TBLB was not correlated with RP-EBUS probe passed through lesions and times of biopsy (P > 0.05). Complications including bleeding, chest pain and pneumothorax recovered spontaneously. Conclusion Non-real-time RP-EBUS guided TBLB was a practical technology for diagnosis of peripheral lung cancer with high diagnostic rate and good safety. Lesion size, connection to visceral pleura, ultrasonic image characteristics and the RP-EBUS probe surrounding by lesion influenced the diagnostic yield. Improvement of operative skills can reduce false negative results.