Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease

In patients with interstitial lung disease (ILD), the most frequent locations of lung cancer are within or near fibrotic lesions. However, the diagnostic yield for peripheral pulmonary lesions (PPLs) within or near fibrotic lesions using endobronchial ultrasonography with a guide sheath transbronchi...

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Autores principales:	Takayasu Ito, Shotaro Okachi, Tomoki Kimura, Kensuke Kataoka, Yasuhiko Suzuki, Fumie Kinoshita, Keiko Wakahara, Naozumi Hashimoto, Yasuhiro Kondoh
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	bronchoscopy endosonography lung neoplasms pulmonary fibrosis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/0602cd6c83d24da1bebb494961cc1902
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spelling	oai:doaj.org-article:0602cd6c83d24da1bebb494961cc19022021-11-25T17:03:35ZEndobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease10.3390/cancers132257512072-6694https://doaj.org/article/0602cd6c83d24da1bebb494961cc19022021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5751https://doaj.org/toc/2072-6694In patients with interstitial lung disease (ILD), the most frequent locations of lung cancer are within or near fibrotic lesions. However, the diagnostic yield for peripheral pulmonary lesions (PPLs) within or near fibrotic lesions using endobronchial ultrasonography with a guide sheath transbronchial biopsy (EBUS-GS TBB) may be unsatisfactory compared to that for PPLs distant from fibrotic lesions because of the difficulty in reaching the lesions. Our objectives were to evaluate the yield for PPLs using EBUS-GS TBB according to the proximity of PPLs to fibrotic lesions and to determine factors affecting the yield for PPLs. We retrospectively investigated 323 consecutive lesions using EBUS-GS TBB between 1 November 2014 and 31 December 2016. We identified PPLs with ILD in such lesions. PPLs with ILD were divided into PPLs within or near fibrotic lesions which met the criterion of PPLs, and of fibrotic lesions overlapping each other (PPLs-FL) and those distant from fibrotic lesions, which met the criterion of PPLs and the area of fibrotic lesion not overlapping each other (PPLs-NFL). Of the 323 lesions, 55 were included (31 PPLs-FL and 24 PPLs-NFL). The diagnostic yield for PPLs-FL was significantly lower than for PPLs-NFL (45.2% vs. 83.3%, <i>p</i> = 0.004). Multivariate analysis revealed that PPLs-NFL (odds ratio (OR) = 7.509) and a probe position within the lesion (OR = 4.172) were significant factors affecting diagnostic yield. Lesion’s positional relation to fibrotic lesions and the probe position were important factors affecting the successful diagnosis via EBUS-GS TBB in these patients.Takayasu ItoShotaro OkachiTomoki KimuraKensuke KataokaYasuhiko SuzukiFumie KinoshitaKeiko WakaharaNaozumi HashimotoYasuhiro KondohMDPI AGarticlebronchoscopyendosonographylung neoplasmspulmonary fibrosisNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5751, p 5751 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bronchoscopy endosonography lung neoplasms pulmonary fibrosis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	bronchoscopy endosonography lung neoplasms pulmonary fibrosis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Takayasu Ito Shotaro Okachi Tomoki Kimura Kensuke Kataoka Yasuhiko Suzuki Fumie Kinoshita Keiko Wakahara Naozumi Hashimoto Yasuhiro Kondoh Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease
description	In patients with interstitial lung disease (ILD), the most frequent locations of lung cancer are within or near fibrotic lesions. However, the diagnostic yield for peripheral pulmonary lesions (PPLs) within or near fibrotic lesions using endobronchial ultrasonography with a guide sheath transbronchial biopsy (EBUS-GS TBB) may be unsatisfactory compared to that for PPLs distant from fibrotic lesions because of the difficulty in reaching the lesions. Our objectives were to evaluate the yield for PPLs using EBUS-GS TBB according to the proximity of PPLs to fibrotic lesions and to determine factors affecting the yield for PPLs. We retrospectively investigated 323 consecutive lesions using EBUS-GS TBB between 1 November 2014 and 31 December 2016. We identified PPLs with ILD in such lesions. PPLs with ILD were divided into PPLs within or near fibrotic lesions which met the criterion of PPLs, and of fibrotic lesions overlapping each other (PPLs-FL) and those distant from fibrotic lesions, which met the criterion of PPLs and the area of fibrotic lesion not overlapping each other (PPLs-NFL). Of the 323 lesions, 55 were included (31 PPLs-FL and 24 PPLs-NFL). The diagnostic yield for PPLs-FL was significantly lower than for PPLs-NFL (45.2% vs. 83.3%, <i>p</i> = 0.004). Multivariate analysis revealed that PPLs-NFL (odds ratio (OR) = 7.509) and a probe position within the lesion (OR = 4.172) were significant factors affecting diagnostic yield. Lesion’s positional relation to fibrotic lesions and the probe position were important factors affecting the successful diagnosis via EBUS-GS TBB in these patients.
format	article
author	Takayasu Ito Shotaro Okachi Tomoki Kimura Kensuke Kataoka Yasuhiko Suzuki Fumie Kinoshita Keiko Wakahara Naozumi Hashimoto Yasuhiro Kondoh
author_facet	Takayasu Ito Shotaro Okachi Tomoki Kimura Kensuke Kataoka Yasuhiko Suzuki Fumie Kinoshita Keiko Wakahara Naozumi Hashimoto Yasuhiro Kondoh
author_sort	Takayasu Ito
title	Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease
title_short	Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease
title_full	Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease
title_fullStr	Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease
title_full_unstemmed	Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease
title_sort	endobronchial ultrasonography with a guide sheath transbronchial biopsy for diagnosing peripheral pulmonary lesions within or near fibrotic lesions in patients with interstitial lung disease
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/0602cd6c83d24da1bebb494961cc1902
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Endobronchial Ultrasonography with a Guide Sheath Transbronchial Biopsy for Diagnosing Peripheral Pulmonary Lesions within or near Fibrotic Lesions in Patients with Interstitial Lung Disease

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