| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 12
| Issue : 3 | Page : 171-176 |
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Predictive factors for a successful diagnostic bronchoscopy of ground-glass nodules
Toshiyuki Nakai1, Yuji Matsumoto1, Fumi Suzuk2, Takaaki Tsuchida1, Takehiro Izumo3
1 Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tukiji Chou-ku, Japan
2 Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tukiji Chou-ku; Department of Pulmonary Medicine, Kameda Medical Center, Kamogawa City, Chiba, Japan
3 Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tukiji Chou-ku; Department of Respiratory Medicine, Japanese Red Cross Medical Center, Hiroo, Shibuya-ku, Tokyo, Japan
Correspondence Address:
Yuji Matsumoto
Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, 5-1-1, Tukiji, Chou-ku, Tokyo 104-0045
Japan
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/atm.ATM_428_16
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Introduction: Since the National Lung Screening Trial demonstrated the utility of low-dose computed tomography screening for lung cancer, the detection rate of ground-glass nodules (GGNs) has increased. Endobronchial ultrasound with a guide sheath (EBUS-GS) is widely performed to diagnose peripheral pulmonary lesions, but there are not enough reports on the predictive ability of EBUS-GS in diagnosing GGNs. The aim of this study is to investigate the predictive factors for a successful diagnostic bronchoscopy for GGNs.
Methods: Consecutive patients who underwent diagnostic bronchoscopy for GGNs from September 2012 to January 2016 were enrolled in this study. From these, cases who underwent EBUS-GS were selected. They were reviewed and analyzed to examine the association between the diagnostic yield and the following clinical factors: lesion size, lobar position, location, consolidation-to-tumor ratio, visibility on X-ray, use of virtual bronchoscopy, bronchus sign, guide sheath size, and number of biopsies.
Results: We enrolled 254 cases, of which 167 were diagnosed using EBUS-GS (65.7% diagnostic yield). Univariate analysis indicated that a positive bronchus sign was a significant factor for higher diagnostic yield (72.9% vs. 34.0%; P < 0.001). The use of virtual bronchoscopy also tended toward a higher yield, but the result was not significant (69.0% vs. 54.4%; P = 0.058). However, multivariate analysis indicated that both were significantly associated with higher diagnostic yield (P < 0.001, odds ratio [OR]: 5.35; P < 0.001, OR: 1.97, respectively).
Conclusions: Our results suggest that a positive bronchus sign and the use of virtual bronchoscopy are positive predictive factors for successful diagnostic bronchoscopy of GGNs.
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