Sci Rep:超声引导下支气管内支气管刷检在周围型非鳞状非小细胞肺癌中的价值

2018-04-12 xiangting MedSci原创

R-EBUS引导下支气管刷检为周围型肺癌患者的诊断和EGFR基因分型提供了额外的取样方法。

径向支气管内超声(R-EBUS)是非小细胞肺癌NSCLC)的一种重要诊断方法。然而,由R-EBUS引导的经支气管活检获得的小样本有时不足以进行病理和分子诊断。此项研究探讨了R-EBUS引导的支气管刷检标本是否适用于NSCLC诊断和EGFR基因分型。

研究纳入了941名接受R-EBUS的外周肺病变患者。对来自非鳞状NSCLC患者的细胞学阳性刷检标本进行EGFR突变分析。624名患者(66.3%)诊断为非鳞状NSCLC。376名患者(60.3%)的刷检样本被发现为细胞学阳性。胸部CT显示有支气管征和R-EBUS探针位于病灶内患者的诊断率更高。363个样本成功进行了EGFR基因分型(细胞学阳性刷检样本的96.5%)。刷检标本和匹配组织样本之间的EGFR基因分型一致性为88.7%(kappa = 0.745,P <0.001)。此外,由R-EBUS引导的经支气管活检病理学诊断或EGER测序失败的144名非鳞状NSCLC患者(23.1%)需要重复活检。但是,57名患者(39.6%)刷检标本的病理学诊断或EGER测序成功。

总之,R-EBUS引导下支气管刷检为周围型肺癌患者的诊断和EGFR基因分型提供了额外的取样方法。

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