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Multivariate Analysis Of The Diagnostic Yield Of Conventional Bronchoscopy In Peripheral Lung Adenocarcinoma

Authors Gao W, Li C, Wang H, Han P, Nie Y

Received 30 August 2019

Accepted for publication 24 October 2019

Published 20 November 2019 Volume 2019:11 Pages 9883—9889

DOI https://doi.org/10.2147/CMAR.S229073

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Eileen O'Reilly


Wei Gao,1 Cuiyun Li,2 Hui Wang,2 Ping Han,2 Yunqiang Nie2

1Department of Blood Screening Test, Linyi People’s Hospital, Linyi 276000, People’s Republic of China; 2Department of Respiratory Medicine, Linyi People’s Hospital, Linyi 276000, People’s Republic of China

Correspondence: Yunqiang Nie
Department of Respiratory Medicine, Linyi People’s Hospital, Linyi 276000, People’s Republic of China
Tel +86 189 5397 1615
Email 1612698346@qq.com

Background: The new subtypes of lung adenocarcinoma reflect local invasive growth, pulmonary alveoli, and intraluminal spreading, while the effective improvement of the diagnostic yield of bronchoscopy still remains unclear. This study aims to explore whether the subtypes of lung adenocarcinoma and other factors affect the diagnostic yield of bronchoscopy.
Methods: All patients were performed 64-row CT examination and bronchoscopy.
Results: The bronchus cutoff sign in 48 cases and the endoscopic diagnostic yield was 60.4%. The lumen of the lobes and segments was invaded in 59 cases, and the endoscopic diagnostic yield was 54.2%.The lymph node metastasis was detected in 46 cases, and the endoscopic diagnostic yield was 60.9%. In addition, 42 cases showed acinar type-predominant, and the endoscopic diagnostic yield was 28.6%. Eighteen cases showed solid type-predominant, and the endoscopic diagnostic yield was 33.3%. The micropapillary type-predominant was noted in 17 cases, with the endoscopic diagnostic yield as 94.1%. The papillary type-predominant was in 14 cases, and the endoscopic diagnostic yield was 42.9%. The lepidic type-predominant was seen in 13 cases, and the endoscopic diagnostic yield was 7.7%. The mean diameter of tumors with a positive endoscopic diagnostic yield was 4.34±2.65cm, and the mean diameter of tumors with a negative diagnostic yield was 2.83±1.47cm. Multivariate analysis showed that micropapillary lung adenocarcinoma affected the endoscopic diagnostic yield (OR=37.594, 95% CI: 4.074–346.94) .Tumor diameter affects endoscopic diagnostic yield (OR=1.39, 95% CI: 1.073–1.802), bronchus cutoff sign is easy to obtain endoscopic diagnostic yield (OR=4.86, 95% CI: 1.606–14.704), and lymph node metastasis affects the endoscopic diagnostic yield (OR=3.696, 95% CI: 1.255–10.883).
Conclusion: The micropapillary subtype lung adenocarcinoma has a certain influence on the diagnostic yield of bronchoscopy. When the lung adenocarcinoma has a large tumor diameter, bronchus cutoff sign and lymph node metastasis, it is easy to obtain a diagnostic yield of bronchoscopy.

Keywords: bronchoscopy, micropapillary type-predominant, lepidic type-predominant, bronchial lumen biopsy, bronchus cut off sign

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