S Eknewir, T J John, S M Bennji, C F N Koegelenberg
{"title":"支气管内超声引导下经支气管针吸术在艾滋病和结核病高发社区的实用性。","authors":"S Eknewir, T J John, S M Bennji, C F N Koegelenberg","doi":"10.7196/AJTCCM.2022.v28i1.156","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the gold standard in diagnosing and performing nodal staging in patients with suspected lung cancer and diagnosing other malignant and benign diseases. Studies from countries with low tuberculosis (TB) incidence suggest that it has a sensitivity of 90 - 95% and a specificity of 100%.</p><p><strong>Objectives: </strong>To investigate the utility of EBUS-TBNA in a community with a high HIV and TB burden.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients who underwent EBUS-TBNA to confirm a tissue diagnosis during a 2-year period from January 2017 - December 2018. Only patients with complete medical, pathology and radiology records and follow-up were included.</p><p><strong>Results: </strong>During the 2 years, a total of 201 patients underwent EBUS-TBNA. Some patients (n=19) had incomplete notes or follow-up and 104 cases were ultimately diagnosed with benign nodal disease. In the 182 patients who were ultimately included in the present study, EBUS-TBNA had a sensitivity of 95.1% (95% confidence interval (CI) 88.6 - 98.2), specificity of 100% (95% CI 94.20 - 100), positive predictive value (PPV) of 100.00% (95% CI 95.3 - 100) and negative predictive value (NPV) of 94.1% (95% CI 86.0 - 97.8) for all diagnoses. The overall diagnostic accuracy was 97.3% (95% CI 93.9 - 99.2). Out of the 64 patients who had lung cancer, EBUS-TBNA had a sensitivity of 95.2% (95% CI 86.7 - 99.0), specificity of 100% (95% CI 5.5 - 100), PPV of 100.0% and NPV of 58.3% (95% CI 31.7 - 80.9). The overall diagnostic accuracy for lung cancer was 95.5% (95% CI 87.2 - 99.1%).</p><p><strong>Conclusion: </strong>EBUS-TBNA has high diagnostic accuracy, even in a population with a high HIV and TB burden.</p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/50/AJTCCM-28-1-156.PMC9255698.pdf","citationCount":"0","resultStr":"{\"title\":\"The utility of endobronchial ultrasound-guided transbronchial needle aspiration in a community with a high HIV and tuberculosis burden.\",\"authors\":\"S Eknewir, T J John, S M Bennji, C F N Koegelenberg\",\"doi\":\"10.7196/AJTCCM.2022.v28i1.156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the gold standard in diagnosing and performing nodal staging in patients with suspected lung cancer and diagnosing other malignant and benign diseases. Studies from countries with low tuberculosis (TB) incidence suggest that it has a sensitivity of 90 - 95% and a specificity of 100%.</p><p><strong>Objectives: </strong>To investigate the utility of EBUS-TBNA in a community with a high HIV and TB burden.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients who underwent EBUS-TBNA to confirm a tissue diagnosis during a 2-year period from January 2017 - December 2018. Only patients with complete medical, pathology and radiology records and follow-up were included.</p><p><strong>Results: </strong>During the 2 years, a total of 201 patients underwent EBUS-TBNA. Some patients (n=19) had incomplete notes or follow-up and 104 cases were ultimately diagnosed with benign nodal disease. In the 182 patients who were ultimately included in the present study, EBUS-TBNA had a sensitivity of 95.1% (95% confidence interval (CI) 88.6 - 98.2), specificity of 100% (95% CI 94.20 - 100), positive predictive value (PPV) of 100.00% (95% CI 95.3 - 100) and negative predictive value (NPV) of 94.1% (95% CI 86.0 - 97.8) for all diagnoses. The overall diagnostic accuracy was 97.3% (95% CI 93.9 - 99.2). Out of the 64 patients who had lung cancer, EBUS-TBNA had a sensitivity of 95.2% (95% CI 86.7 - 99.0), specificity of 100% (95% CI 5.5 - 100), PPV of 100.0% and NPV of 58.3% (95% CI 31.7 - 80.9). The overall diagnostic accuracy for lung cancer was 95.5% (95% CI 87.2 - 99.1%).</p><p><strong>Conclusion: </strong>EBUS-TBNA has high diagnostic accuracy, even in a population with a high HIV and TB burden.</p>\",\"PeriodicalId\":52847,\"journal\":{\"name\":\"African Journal of Thoracic and Critical Care Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-05-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/50/AJTCCM-28-1-156.PMC9255698.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"African Journal of Thoracic and Critical Care Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.7196/AJTCCM.2022.v28i1.156\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"African Journal of Thoracic and Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7196/AJTCCM.2022.v28i1.156","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景:支气管内超声引导下经支气管针吸术(EBUS-TBNA)已成为诊断疑似肺癌患者和进行结节分期以及诊断其他恶性和良性疾病的金标准。结核病(TB)发病率较低的国家的研究表明,其敏感性为 90% - 95%,特异性为 100%:调查 EBUS-TBNA 在艾滋病和结核病高发社区的实用性:我们回顾性审查了 2017 年 1 月至 2018 年 12 月两年期间接受 EBUS-TBNA 确诊组织诊断的所有患者。仅纳入有完整医疗、病理和放射记录及随访的患者:2年间,共有201名患者接受了EBUS-TBNA检查。部分患者(19 例)的病历或随访记录不完整,104 例最终被诊断为良性结节病。在最终纳入本研究的 182 例患者中,EBUS-TBNA 对所有诊断的敏感性为 95.1%(95% 置信区间 (CI) 88.6 - 98.2),特异性为 100%(95% CI 94.20 - 100),阳性预测值 (PPV) 为 100.00%(95% CI 95.3 - 100),阴性预测值 (NPV) 为 94.1%(95% CI 86.0 - 97.8)。总体诊断准确率为 97.3% (95% CI 93.9 - 99.2)。在 64 名肺癌患者中,EBUS-TBNA 的灵敏度为 95.2%(95% CI 86.7 - 99.0),特异性为 100%(95% CI 5.5 - 100),PPV 为 100.0%,NPV 为 58.3%(95% CI 31.7 - 80.9)。肺癌的总体诊断准确率为 95.5% (95% CI 87.2 - 99.1%):EBUS-TBNA具有很高的诊断准确性,即使在HIV和结核病负担较重的人群中也是如此。
The utility of endobronchial ultrasound-guided transbronchial needle aspiration in a community with a high HIV and tuberculosis burden.
Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the gold standard in diagnosing and performing nodal staging in patients with suspected lung cancer and diagnosing other malignant and benign diseases. Studies from countries with low tuberculosis (TB) incidence suggest that it has a sensitivity of 90 - 95% and a specificity of 100%.
Objectives: To investigate the utility of EBUS-TBNA in a community with a high HIV and TB burden.
Methods: We retrospectively reviewed all patients who underwent EBUS-TBNA to confirm a tissue diagnosis during a 2-year period from January 2017 - December 2018. Only patients with complete medical, pathology and radiology records and follow-up were included.
Results: During the 2 years, a total of 201 patients underwent EBUS-TBNA. Some patients (n=19) had incomplete notes or follow-up and 104 cases were ultimately diagnosed with benign nodal disease. In the 182 patients who were ultimately included in the present study, EBUS-TBNA had a sensitivity of 95.1% (95% confidence interval (CI) 88.6 - 98.2), specificity of 100% (95% CI 94.20 - 100), positive predictive value (PPV) of 100.00% (95% CI 95.3 - 100) and negative predictive value (NPV) of 94.1% (95% CI 86.0 - 97.8) for all diagnoses. The overall diagnostic accuracy was 97.3% (95% CI 93.9 - 99.2). Out of the 64 patients who had lung cancer, EBUS-TBNA had a sensitivity of 95.2% (95% CI 86.7 - 99.0), specificity of 100% (95% CI 5.5 - 100), PPV of 100.0% and NPV of 58.3% (95% CI 31.7 - 80.9). The overall diagnostic accuracy for lung cancer was 95.5% (95% CI 87.2 - 99.1%).
Conclusion: EBUS-TBNA has high diagnostic accuracy, even in a population with a high HIV and TB burden.