Effectiveness of a modified biopsy technique in endobronchial ultrasound (EBUS) in the diagnosis of peripheral lung neoplasms: results of a clinical study

Abstract

Introduction. The problem of lung malignant neoplasms diagnosis is extremely urgent. Verification of peripheral lung malignancies using ultrasound bronchoscopy does not exceed 70.6 %.The aim of the work is to demonstrate an increase in the verification of peripheral lung malignancies by endobronchial lung ultrasound examination.Materials and methods The study was conducted on the basis of the endoscopic department of the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine from 2019 to 2021, in which 142 patients were included. The patients were divided into 2 groups. The main group included 68 patients whose examination included fibrobronchoscopy with endo ultrasound with biopsy according to a modified technique. The comparison group included 74 patients who underwent ultrasound bronchoscopy with biopsy according to the standard technique. The manipulation time with biopsy according to the standard technique ranged from 12 to 42 minutes, on the average 29 ± 5 minutes. Ultrasound bronchoscopy with biopsy to the modified technique lasted from 14 to 44 minutes, on average – 30 ± 5 minutes.Results The modified technique of biopsy with endosonographic control of endoscopic instrument position in the pathological focus during ultrasound bronchoscopy allows to increase the percentage of peripheral lung malignant neoplasms verification by 19.8% (p < 0.05). Ultrasound bronchoscopy with biopsy according to a modified technique is a relatively safe manipulation, complications were detected in 2.9 % of patients and were successfully treated conservatively.Discussion Endobronchial ultrasound examination of the lungs is a sufficiently effective and informative technique. Introduction of modified biopsy technique into clinical practice and its wide application will allow to replace more invasive and traumatic diagnostic procedures, to increase informative value of ultrasound bronchoscopy.Conclusion The use of a modified biopsy technique during ultrasound bronchoscopy will increase the verification by 19.8 % (p < 0.05), thus allowing to reduce the period of examination of patients and prescribe antitumor treatment earlier.