Predictive value of the resistance of the probe to pass through the lesion in the diagnosis of peripheral pulmonary lesions using radial probe endobronchial ultrasound with a guide sheath

Frontiers in Oncology, Год журнала: 2023, Номер 13

Опубликована: Июль 31, 2023

Transbronchial lung biopsy guided by radial probe endobronchial ultrasonography with a guide sheath (EBUS-GS-TBLB) is becoming significant approach for diagnosing peripheral pulmonary lesions (PPLs). We aimed to explore the clinical value of resistance pass through lesion in diagnosis PPLs when performing EBUS-GS-TBLB, and determine optimum number EBUS-GS-TBLB.We performed prospective, single-center study 126 consecutive patients who underwent EBUS-GS-TBLB solid positive-bronchus-sign where was located within from September 2019 May 2022. The classification each carried out two bronchoscopists independently, final result depended on bronchoscopist responsible procedures. primary endpoint diagnostic yield according pattern. secondary endpoints were factors affecting yield. Procedural complications also recorded.The total 77.8%, including 83.8% malignant 67.4% benign diseases (P=0.033). Probe type II displayed highest (87.5%), followed III (81.0%) I (61.1%). A difference between detected (P = 0.008), whereas others did not. Although most definitive using or could be diagnosed first biopsy, fourth contributed sufficient samples. In contrast, considerably limited tissue specimens obtained I. inter-observer agreement blinded excellent (κ 0.84).The useful predictive factor successful lesion. Four serial biopsies are appropriate both III, additional procedures needed

Язык: Английский

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Predictive value of serum SCCA and CYFRA21-1 levels on radiotherapy efficacy and prognosis in patients with non-small cell lung cancer

Biotechnology and Genetic Engineering Reviews, Год журнала: 2023, Номер 40(4), С. 4205 - 4214

Опубликована: Май 8, 2023

Monitoring changes in serum tumor marker concentrations can help the early diagnosis of non-small cell lung cancer (NSCLC). However, there are few methods to monitor efficacy and prognosis radiotherapy NSCLC patients. The present research aimed explore correlation between squamous carcinoma antigen (SCCA) cytokeratin 19 soluble fragment (CYFRA21-1) levels Serum CYFRA21-1 SCCA were detected with an automatic chemiluminescence immunoassay analyzer. Patients followed up by telephone at regular intervals for 35 months. χ2 test was used compare clinical characteristics such as age, gender, smoking history other count data groups. Predictive value on analyzed Receiver Operating Characteristic (ROC) curves. survival patients Kaplan–Meier method. group apparently higher comparison control group. concentration both positive relevant Tumor Node Metastasis (TNM) stage. Area Under Curve (AUC) 0.732 0.721, respectively. In addition, high could predict poor outcomes. have shorter times. High unfavorable invalids NSCLC.

Язык: Английский

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Needle‐based confocal laser endomicroscopy for real‐time granuloma detection

Respirology, Год журнала: 2023, Номер 28(10), С. 934 - 941

Опубликована: Авг. 10, 2023

Needle-based confocal laser endomicroscopy (nCLE) allows real-time microscopic imaging at the needle tip. nCLE malignancy criteria are used for tool-in-lesion confirmation during bronchoscopic lung nodule analysis. However, to date, granulomas lacking. The aim was identify and validate granuloma assess if blinded raters can distinguish malignant from granulomatous videos.In patients with suspected sarcoidosis, nCLE-imaging of mediastinal lymph nodes performed endoscopic ultrasound procedures, followed by aspiration. were identified comparison pathology final diagnoses. Additionally, nCLE-videos nodules part prospective trials clinical care compared proposed criteria. Blinded validated videos sarcoid reactive twice.Granuloma (brighter-toned, homogeneous well-demarcated lesions) based on in 14 sarcoidosis patients. Raters evaluated 26 obtained (n = 15 sarcoidosis; n 11 total 260 ratings). Granuloma recognized 88% accuracy. inter-observer (κ 0.63, 95% CI 0.54-0.72) intra-observer reliability 0.70 ± 0.06) substantial. Based 12 4 granulomas, 6 malignancy, 2 + 120 ratings) 92% 75% accuracy.nCLE facilitates visualization. accurately consistently distinguished malignancy. Our data show potential as a guidance tool

Язык: Английский

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Bronchoscopic treatment of early-stage peripheral lung cancer

Current Opinion in Pulmonary Medicine, Год журнала: 2024, Номер 30(4), С. 337 - 345

Опубликована: Апрель 29, 2024

This review article focuses on bronchoscopic treatment of early-stage peripheral lung cancer.

Язык: Английский

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Bronchoscopy with and without needle-based confocal laser endomicroscopy for peripheral lung nodule diagnosis: protocol for a multicentre randomised controlled trial (CLEVER trial)

BMJ Open, Год журнала: 2024, Номер 14(7), С. e081148 - e081148

Опубликована: Июль 1, 2024

Introduction Despite many technological advances, the diagnostic yield of bronchoscopic peripheral lung nodule analysis remains limited due to frequent mispositioning. Needle-based confocal laser endomicroscopy (nCLE) enables real-time microscopic feedback on needle positioning, potentially improving sampling location and yield. Previous studies have defined validated nCLE criteria for malignancy, airway parenchyma. Larger demonstrating effect are lacking. We aim investigate if nCLE-imaging integrated with conventional bronchoscopy results in a higher compared without nCLE. Methods This is parallel-group randomised controlled trial. Recruitment performed at pulmonology outpatient clinics universities general hospitals six different European countries one hospital USA. Consecutive patients malignancy suspected (10–30 mm) an indication will be screened, 208 included. Web-based randomisation (1:1) between two procedures performed. The primary outcome Secondary outcomes include sensitivity repositionings, procedure fluoroscopy duration, complications. Pathologists blinded type; endoscopists not. Ethics dissemination Primary approval by Committee Amsterdam University Medical Center. Dissemination involves publication peer-reviewed journal. Support Financial material support from Mauna Kea Technologies. Trial registration number NCT06079970 .

Язык: Английский

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Remotely operated robotic microscopy for rapid diagnosis of bronchoscopic cytology specimens

Diagnostic Cytopathology, Год журнала: 2023, Номер 51(9), С. 554 - 562

Опубликована: Июнь 8, 2023

Obtaining a diagnosis and treating pulmonary malignancies during the same anesthesia requires either an on-site pathologist or system for remotely evaluating microscopic images. Cytology specimens are challenging to assess given need navigate through dispersed three-dimensional cell clusters. Remote navigation is possible using robotic telepathology, but data limited on ease of use current systems, particularly cytology.Air dried modified Wright-Giemsa stained slides from 26 touch preparations transbronchial biopsies 27 smears endobronchial ultrasound guided fine needle aspirations were scored adequacy assessment (rmtConnect Microscope) non-robotic telecytology platforms. Diagnostic classifications compared between glass assessments.Compared telecytology, had greater non-inferior diagnosis. The median time was 85 s (range 28-190 s). categories concordant 76% cases in versus 78% slide Weighted Cohen's kappa scores agreement these comparisons 0.84 0.72, respectively.Use remote-controlled microscope improved enabled strongly diagnoses be expediently rendered. This study provides evidence that modern feasible user-friendly method potentially intraoperatively rendering assessments bronchoscopic cytology specimens.

Язык: Английский

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Design and Nonlinear Error Compensation of a Multi-Segment Soft Continuum Robot for Pulmonary Intervention

IEEE Transactions on Medical Robotics and Bionics, Год журнала: 2023, Номер 5(4), С. 832 - 842

Опубликована: Авг. 30, 2023

Interventional lung biopsy is an effective way to diagnose diseases. However, traditional bronchoscopy lacks maneuverability in complex bronchi. A multi-segment soft continuum robot with full-dimensional bending capability proposed this study. The manipulator features a 3.5 mm outer diameter and 2.6 internal working channel. Mechanical assembly, hysteresis, friction, drive rope extension nonlinear errors lead deviations the kinematic model of robot. hybrid includes decoupling constant curvature coupled particle swarm optimization-based back propagation neural network error compensation model. dual-joystick master-slave heterogeneous operation mode based on configuration space incremental mapping. used complete position accuracy comparison experiments With model, mean Euclidean single-segment motion experiment improved by about 60%. double-segment 70%. Pulmonary intervention target sampling are performed bronchial lung. experimental results indicate that has dexterous guidance potential utility.

Язык: Английский

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Thirty-Day Complications, Unplanned Hospital Encounters, and Mortality after Endosonography and/or Guided Bronchoscopy: A Prospective Study

Cancers, Год журнала: 2023, Номер 15(18), С. 4531 - 4531

Опубликована: Сен. 12, 2023

Limited data exist regarding the adverse events of advanced diagnostic bronchoscopy, with most available information derived from retrospective datasets that primarily focus on early complications. We conducted a 15-month prospective cohort study among consecutive patients undergoing endosonography and/or guided bronchoscopy under general anesthesia. evaluated 30-day incidence severe complications, any complication, unplanned hospital encounters, and deaths. Additionally, we analyzed time onset (immediate, within 1 h procedure; early, h-24 h; late, 24 h-30 days) identified risk factors associated these events. Thirty-day were for 697 out 701 (99.4%) enrolled patients, 85.6% having suspected malignancy multiple comorbidities (median Charlson Comorbidity Index (IQR): 4 (2-5)). Severe complications occurred in only 17 (2.4%) but them, 10 (58.8%) had encounters 2 (11.7%) died 30 days. A significant proportion procedure-related (8/17, 47.1%); (8/11, 72.7%); two deaths days or weeks after procedure. Low-dose attenuation biopsy site computed tomography was independently complication (OR: 1.87; 95% CI 1.13-3.09); 2.17; 1.10-4.30); mortality 4.19; 1.74-10.11). arising although uncommon, have clinical consequences. substantial occur procedure, potentially going unnoticed exerting negative impact if proactive surveillance program is not implemented.

Язык: Английский

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Primary pulmonary adenoid cystic carcinoma: A clinicopathological study of 64 patients

Thoracic Cancer, Год журнала: 2023, Номер 15(5), С. 386 - 393

Опубликована: Дек. 26, 2023

This study aimed to investigate the clinicopathological features and prognostic indicators of primary pulmonary adenoid cystic carcinoma (PACC). Clinical data were collected from 64 PACC patients analyzed retrospectively at Tianjin Medical University General Hospital, West China Hospital Sichuan University, First Affiliated Guangxi Bishan Chongqing January 2003 August 2023. The (28 males 36 females) aged 20 73 years, with a median age 49 years an average 49.3 years. Immunohistochemical staining showed that tumors expressed CK7, S-100 protein, CK5/6, CD117, p63. Seven underwent fluorescence in situ hybridization (FISH) testing three found have myeloblastosis (MYB) gene translocation. In total, 53 surgery, among whom 31 received only surgery 22 both postoperative chemoradiotherapy. addition, 10 chemoradiotherapy only, while one patient treatment traditional Chinese medicine. overall survival rates first, third, fifth 98.4%, 95.3%, 87.5%, respectively. Prognostic analysis revealed age, tumor size, lymph node metastasis status, margin choice modality significantly influenced patients' prognosis.

Язык: Английский

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Ultrasound-Guided Needle Aspiration Biopsy of Superficial Metastasis of Lung Cancer with and without Rapid On-Site Evaluation: A Randomized Trial

Cancers, Год журнала: 2022, Номер 14(20), С. 5156 - 5156

Опубликована: Окт. 21, 2022

Studies which evaluated the role of an ultrasound-guided needle aspiration biopsy (US-NAB) metastases from lung cancer located in "superficial" organs/tissues are scant, and none them assessed possible impact rapid on-site evaluation (ROSE) on diagnostic accuracy safety outcomes. Consecutive patients with suspected superficial were randomized 1:1 to US-NAB without (US-NAB group) or ROSE (ROSE group). The yield for a tissue diagnosis was primary outcome. Secondary outcomes included genotyping, PD-L1 testing, safety. During study period, 136 receive (n = 68) 68). We found no significant differences between group terms yields (94.1% vs. 97%, respectively; p 0.68), genotyping (88% 91.8%, 0.56), testing (93.5% 90.6%, 0.60). Compared procedures, non-diagnostic procedures characterized by less common use cutting (66.6% 96.9%, 0.0004) retrieval core (37.5% 98.5%; 0.0001). Only one adverse event (vasovagal syncope) recorded. is safe has excellent success regardless availability ROSE. These findings provide strong rationale using as first-step method acquisition whenever metastatic lesion identified cancer.

Язык: Английский

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