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首页> 外文期刊>Surgical Endoscopy >Multivariate study of predictive factors for clearly defined lung lesions without visible endobronchial lesions in transbronchial biopsy.
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Multivariate study of predictive factors for clearly defined lung lesions without visible endobronchial lesions in transbronchial biopsy.

机译：经支气管活检的无明确支气管内病变的明确定义肺部病变预测因素的多变量研究。

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BACKGROUND: Although the diagnostic validity and predictive factors for the diagnostic yield of transbronchial biopsy (TBB) of clearly defined pulmonary lesions with no visible endobronchial lesion have been analyzed in numerous studies, very few have used multivariate analysis techniques to evaluate the validity of TBB as a diagnostic tool or to analyze the independent influence of clearly dependent variables, such as the bronchus sign and lesion size. METHODS: We retrospectively analyzed all cases in which this type of lesion underwent TBB under fluoroscopic control between 2006 and 2008. The analyzed variables included lesion size, localization, the presence of the bronchus sign, and the final result obtained. We performed a descriptive analysis of the TBB results and a multivariate analysis of the predictive factors for the results using logistic regression techniques. RESULTS: A total of 273 patients (206 males, 75.5%) were included in the study. The average lesion diameter was 34 (+/- 16) mm, with 24% 2 cm or smaller. Twenty-eight percent of the lesions were localized in the lower lobes and 32% in the peripheral third of the lung. The bronchus sign was present in 28% of the patients. Seventy-eight percent of the patients had primary or metastatic malignant lung lesions, the rest were benign lesions of diverse etiology. TBB was diagnostic in 45.4% of cases. In the multivariate analysis, the only independent predictors of outcome were malignant etiology (OR = 4.8; 95% CI = 2.210.4), diameter >20 mm (OR = 3.6; 95% CI = 1.8-7.3), and the presence of the bronchus sign (OR = 2.4; 95% CI = 1.3-4.3). CONCLUSIONS: TBB of lesions clearly delimited without an endobronchial lesion can lead to diagnosis in almost half of the patients. The nature of the lesion, diameter >20 mm, and the presence of the bronchus sign are independent predictors of outcome.
机译：背景：尽管在众多研究中分析了明确定义的无病变支气管内病变的经皮支气管活检（TBB）的诊断有效性和预测因素，但很少有人使用多元分析技术评估TBB的有效性。诊断工具或分析明确相关变量（例如支气管征和病变大小）的独立影响的工具。方法：我们回顾性分析了2006年至2008年在荧光检查下该类型病变行TBB的所有病例。分析的变量包括病变大小，定位，支气管征的存在以及最终结果。我们使用逻辑回归技术对TBB结果进行了描述性分析，并对结果的预测因素进行了多变量分析。结果：本研究共纳入273例患者（206例男性，占75.5％）。平均病变直径为34（+/- 16）mm，其中24％2 cm或更小。 28％的病灶位于下肺叶，32％的病灶位于肺的外围三分之一。 28％的患者存在支气管征。 78％的患者患有原发性或转移性恶性肺部病变，其余为各种病因的良性病变。 TBB在45.4％的病例中具有诊断意义。在多变量分析中，结果的唯一独立预测因素是恶性病因（OR = 4.8; 95％CI = 2.210.4），直径> 20 mm（OR = 3.6; 95％CI = 1.8-7.3）以及是否存在支气管征（OR = 2.4; 95％CI = 1.3-4.3）。结论：明确界定的TBB病变无支气管内病变可在几乎一半的患者中导致诊断。病变的性质，直径> 20 mm和支气管征的存在是预后的独立预测因子。

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