电子支气管镜联合窄带成像技术对癌性胸腔积液的诊断价值

Combination of electronic bronchoscope and narrow band imaging (NBI) in diagnosis of carcinomatous hydrothorax

摘要:

摘要：目的  评估电子支气管镜替代内科胸腔镜并联合窄带成像技术（NBI）在癌性胸腔积液诊断中的价值。方法 选择怀疑癌性胸腔积液的患者89例，应用Olympus BF-1T 260电子支气管镜替代内科胸腔镜，常规方法进入胸膜腔后，先进行白光支气管镜（WLB）观察，再使用NBI模式观察，分别在两种模式下于病变胸膜各取5块组织送检。比较WLB、NBI两种方法的敏感度与特异度及活检后出血情况。结果 89例怀疑癌性胸腔积液的患者，WLB镜下阳性85例，阴性4例，活检后出血6例占6.70%。与病理结果对比，WLB敏感性97.50%，特异性22.22%。NBI镜下阳性68例，阴性21例，活检无活动性出血发生。与病理结果对比，NBI的敏感性86.67%，特异性78.57%。WLB与NBI相比，前者敏感性优于后者，后者特异性优于前者。两者的敏感性与特异性的比较差异均有统计学意义（P <0.05）。结论 电子支气管镜替代内科胸腔镜对癌性胸腔积液具有较高的诊断率，联合窄谱成像技术能提高活检的准确性与安全性。

Abstract:

Abstract: Objective To evaluate the value of the electron bronchoscopy in diagnosis of carcinothoracic fluid in the case of replacing medical thoracoscopy and combining narrow-band imaging (NBI). Methods 89 cases of suspected cancerous pleural effusion patients, used electronic bronchoscope Olympus BF-1T 260 in place of medical thoracoscopy to enter pleural cavity in the usual way. First observed by white light bronchoscopy (WLB), then by narrow-band imaging (NBI) and take 5 pieces of tissue out respectively on the pleura of the lesion for pathological examination. Then compare the sensitivity and specificity of WLB and NBI methods, and the bleeding after biopsy. Result Among 89 cases of suspected cancerous pleural effusion patients, 85 cases found positive by white light bronchoscopy (WLB) , negative in 4 cases, 6 cases bleeding after biopsy (6.70%). Compared with the pathological results, WLB sensitivity 97.50%, specificity 22.22%. 68 cases found positive by NBI, negative 21 cases, no active bleeding after biopsy. Compared with the pathological results, the sensitivity of the NBI 86.67%, specificity 78.57%. Compared WLB with NBI, the former’s sensitivity is superior to the latter, the latter’s specificity is superior to the former. Both comparisons about sensitivity diagnosis of the and specificity are statistically significant (P < 0.05).  Conclusion Electronic bronchial in place of medical thoracoscopy has high diagnostic rate in the carcinothoracic fluid, and the combination of NBI can improve the accuracy and security of the biopsy.