title: [Factors Associated with Diagnostic Yield of Endobronchial Ultrasonography with a Guide Sheath for Peripheral Lung Cancer].
abstract: Endobronchial ultrasonography with a guide sheath (EBUS-GS) has recently been used for improved diagnostic yields for peripheral pulmonary lesions. This study retrospectively evaluated the factors related to the diagnostic yield of EBUS-GS for peripheral lung cancer. The medical records of 76 patients who had been diagnosed with lung cancer and had undergone bronchoscopy with EBUS-GS in our hospital between August 2014 and September 2015 were reviewed. The total diagnostic ratio of peripheral lung cancer was 71.1%. The following factors of the diagnostic yield were evaluated: location of pulmonary lesion; size; feature; bronchus sign; location of EBUS probe; EBUS detection; number of biopsies performed; procedure time; use of virtual bronchoscopic navigation; use of EBUS-guided transbronchial needle aspiration with EBUS-GS; CT slice thickness; operator's years of medical experience; and specialized training in bronchoscopy at the National Cancer Center. In all cases, lesion size ≧ 20 mm (80.8% vs. 50.0%, P = 0.006), EBUS probe location "within" (90.0% vs. 50.0%, P < 0.001), EBUS detection (80.7% vs. 28.6%, P < 0.001), number of biopsies ≧ 5 (78.0% vs. 47.1%, P = 0.013), and bronchoscopy training (81.6% vs. 60.5%, P = 0.043) significantly contributed to an increase in the diagnostic yield. Following a multivariate analysis, EBUS probe location "within" was found to be the most significant factor affecting the diagnostic yield (odds ratio 14.10, 95% CI 3.53-56.60, P < 0.001), and bronchoscopy training was the second most significant factor (odds ratio 6.93, 95% CI 1.86-25.80, P = 0.004). EBUS probe location "within" and bronchoscopy training are the most important factors for improved diagnostic yield by bronchoscopy with EBUS-GS for peripheral lung cancer.
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Uchimura
authors.forename: Kei
authors.initials: K
authors.lastname: Yamasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishimoto
authors.forename: Sho
authors.initials: S
authors.lastname: Kakinouchi
authors.forename: Koki
authors.initials: K
authors.lastname: Kimura
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kanaya
authors.forename: Takafumi
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Takako
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sakagami
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Hata
authors.forename: Shuhei
authors.initials: S
authors.lastname: Ideguchi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takaki
authors.forename: Tomoko
authors.initials: T
authors.lastname: Shiraishi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Akata
authors.forename: Minako
authors.initials: M
authors.lastname: Hanaka
authors.forename: Chinatsu
authors.initials: C
authors.lastname: Nishida
authors.forename: Takashi
authors.initials: T
authors.lastname: Kido
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yatera
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mukae
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D000368:Aged; D000369:Aged, 80 and over; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies