Ender LEVENT, Ferda AKSOY, Attila SAYGI, Nursel YAYLI, Gül DABAK

Akciğer malignitesi tanısında bronkoskopik dar bantlı görüntüleme tekniği

Amaç: Bu çalışmada, bronkoskopik dar bantlı görüntülemenin (NBI) kanseröz, prekanseröz ve nüks malign lezyonlardaki tanısal değeri ve beyaz ışık bronkoskopisine (WLB) üstünlüğü olup olmadığı araştırıldı. Ayrıca WLB ile birlikte kullanıldığında biyopsi başarısına katkısı olup olmadığı da değerlendirildi. Çalışma planı: Bu prospektif ve kısmi kör çalışmada, Mayıs 2006 - Aralık 2008 tarihleri arasında bronkoskopi endikasyonu olan 18 yaş ve üstü 30 hasta (27 erkek, 3 kadın; ort. yaş 62±8 yıl dağılım 44-82 yıl) değerlendirildi. Önce WLB ile ardından NBI ile bronkoskopi yapıldı. Normal ve anormal görünümlü dokulardan toplam 81 biyopsi örneği alındı. Bulgular: NBI tekniğinin duyarlılığı %50.0; özgüllüğü %54.9; pozitif kestirim değeri %39.47 ve negatif kestirim değeri ise %65.12 idi. WLB tekniğinin duyarlılığı %56.66, özgüllüğü %64.71, pozitif kestirim değeri %48.57, negatif kestirim değeri ise %71.74 idi. WLB bulgularının normal olduğu bölgelerde NBI tekniği ile malignite yakalama oranı %6.25 oldu. Sonuç: Bizim sonuçlarımız dar bantlı görüntüleme tekniğinin kullanımının, akciğer malignitesi ön tanılı hastalarda tanıya katkı açısından WLBye üstünlüğü gösterilemedi.

Bronchoscopic narrow band imaging technique in diagnosis of lung malignanc

Background: In this study, we aimed to investigate the diagnostic value of bronchoscopic narrow-band imaging (NBI) in cancerous, precancerous and recurrent malignant lesions and whether NBI was superior to white light bronchoscopy (WLB). We also evaluated whether the combination of NBI and WLB might contribute to the success of a biopsy. Methods: Between May 2006 and December 2008, 30 patients (27 males, 3 females; mean age 62±8 years; range 44 to 82 years) with indication for bronchoscopy, 18 years of age and over were evaluated in this prospective and partially blinded study. The NBI with the bronchoscopy was performed, followed by WLB. A total of 81 biopsy samples were taken from the tissue with normal and abnormal appearance. Results: The sensitivity of NBI technique was 50.0%, the specificity was 54.9%, the positive predictive value was 39.47% and negative predictive value was 65.12%. The sensitivity of WLB technique was 56.66%, the specificity was 64.71%, the positive predictive value was 48.57% and negative predictive value was 71.74%. The malignancy detection rate of NBI technique was 6.25% in areas with normal findings on WLB. Conclusion: Our results showed that the use of the NBI technique was not superior to WLB in terms of contribution for the diagnosis in patients with a preliminary diagnosis of lung malignancy.

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