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首页> 外文期刊>Journal of bronchology & interventional pulmonology >The Diagnostic Accuracy and Sensitivity for Malignancy of Radial-Endobronchial Ultrasound and Electromagnetic Navigation Bronchoscopy for Sampling of Peripheral Pulmonary Lesions
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The Diagnostic Accuracy and Sensitivity for Malignancy of Radial-Endobronchial Ultrasound and Electromagnetic Navigation Bronchoscopy for Sampling of Peripheral Pulmonary Lesions

机译：径向 - 内核超声波超声波和电磁导航支气管镜检查的诊断准确性和灵敏度，用于外周肺部病变的取样

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Background: Lung cancer screening with computed tomography chest is identifying peripheral pulmonary lesions (PPLs) suspicious for early-stage lung cancer at increasing rates. Radial-endobronchial ultrasound (R-EBUS) and electromagnetic navigation bronchoscopy (ENB) are 2 methods to sample PPLs to diagnose and treat early lung cancer. ENB has a higher operating financial cost, however, the rationale for its use is possible higher diagnostic accuracy versus R-EBUS. Objective: The objective of this study was to determine the comparative diagnostic accuracy, sensitivity, and negative predictive value for R-EBUS and ENB in sampling PPLs. Methods: A systematic review and meta-analysis were conducted. The Ovid Medline database was queried for original research reporting a diagnostic yield of R-EBUS or ENB for PPLs identified on computed tomography chest suspicious for malignancy. The I ~(2)statistic assessed study heterogeneity. Random effects models produced pooled estimates of diagnostic accuracy and sensitivity for malignancy. Reasons for heterogeneity were explored with meta-regression. Publication bias and small study effects were assessed. Results: A total of 41 studies involved 2988 lung nodules (R-EBUS 2102, ENB 886) in 3204 patients (R-EBUS 2097, ENB 1107). Overall sensitivity to detect cancer was 70.7% [95% confidence interval (CI): 67.2-74.0]; R-EBUS 70.5% (95% CI: 66.1-74.8), ENB 70.7% (95% CI: 64.7-76.8). Pooled overall diagnostic accuracy was 74.2% (95% CI: 71.0-77.3); R-EBUS 72.4% (95% CI: 68.7-76.1), ENB 76.4% (95% CI: 70.8-82.0). The localization modalities had comparative safety profiles of <2% complications. Conclusion: Both technologies have a high proportion of successful PPL localization with similar sensitivity for malignancy and accuracy. As such, both reasonable options for health care authorities to employ diagnostic algorithms.
机译：背景：使用计算机断层扫描胸部的肺癌筛选是在增加率时识别用于早期肺癌的外周肺病变（PPLS）。径向 - 内核超声（R-EBUS）和电磁导航支气管镜（eNB）是样品以诊断和治疗早期肺癌的2种方法。 eNB具有更高的经营财务成本，但是，其使用的理由是诊断准确性更高的诊断准确性与R-EBUS。目的：本研究的目的是确定采样PPLS中R-EBUS和eNB的比较诊断准确性，敏感性和负预测值。方法：进行系统审查和荟萃分析。询问OVID MEDLINE数据库对于原始研究报告，报告R-EBUS或eNB的诊断产量，用于对恶性肿瘤的计算机断层摄影胸部识别的PPLS。 I〜（2）统计评估研究异质性。随机效果模型产生了对恶性肿瘤诊断准确性和敏感性的汇总估计。使用Meta-Rescollion探讨了异质性的原因。评估出版物偏见和小型研究效果。结果：共有41项研究涉及3204名患者（R-EBUS 2097，ENB 1107）中的2988肺结节（R-EBUS 2102，ENB 886）。检测癌症的总体敏感性为70.7％[95％置信区间（CI）：67.2-74.0]; R-EBUS 70.5％（95％CI：66.1-74.8），ENB 70.7％（95％CI：64.7-76.8）。汇集整体诊断准确性为74.2％（95％CI：71.0-77.3）; R-EBUS 72.4％（95％CI：68.7-76.1），ENB 76.4％（95％CI：70.8-82.0）。本地化方式具有比较安全性<2％的并发症。结论：两种技术都具有高比例的PPL定位，具有类似的恶性和准确性的敏感性。因此，卫生保健机构的合理选择都采用诊断算法。

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