Improving the quality of diagnosis and verification of peripheral lung neoplasms by using a modified biopsy technique for ultrasonic bronchoscopy (EBUS)

BACKGROUND: The problem of diagnosis and treatment of malignant neoplasms of the lungs is extremely relevant. Verification of the malignant process in the case of peripheral localization of the neoplasm in the lung when using ultrasound bronchoscopy does not exceed 70.6%.

AIMS: This study aimed to improve the effectiveness of ultrasound bronchoscopy in the State Medical Institution Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine by introducing into clinical practice a modified biopsy technique for ultrasound bronchoscopy. The technique is patented, patent for invention no. RU2719666 C1.

MATERIALS AND METHODS: From 2019 to 2021, a study was conducted based on the endoscopic department of the State Medical Institution Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine, which included 137 patients. The patients were divided into two groups: the main group included 66 patients in whose examination FBS with endoussis with biopsy by a modified technique was used; the comparison group included 71 patients who underwent ultrasound bronchoscopy with biopsy by a standard technique. The time of biopsy manipulation according to the standard procedure ranged from 14 to 41 min, averaging 30±5 min. Ultrasound bronchoscopy with biopsy by a modified technique lasted from 16 to 45 minutes, on average 31±5 min.

RESULTS: In the main group, where FBS with ENDOUSSI with biopsy was used in the diagnosis of patients using a modified technique with endosonographic control of the position of the endoscopic instrument in the pathological focus, the diagnosis of malignant neoplasm was verified in 52 patients (in 78.8% of cases). In the comparison group, where the standard biopsy technique was used in patients with ultrasound bronchoscopy, the diagnosis of malignant neoplasm was verified in 41 patients (in 57.7% of cases). Thus, the verification of peripheral lung malignancies when using a modified biopsy technique increases by 21.1% (p <0.05). FBS with endoussis with biopsy using a modified technique is satisfactorily tolerated by patients and is a relatively safe manipulation.

CONCLUSION: modified biopsy technique developed by us with endosonographic control of the position of the endoscopic instrument in the pathological focus during ultrasound bronchoscopy makes it possible to increase the percentage of verification of peripheral lung malignancies by 21.1% (p <0.05). The introduction and widespread use of the modified biopsy technique for ultrasound bronchoscopy in the diagnosis of peripheral lung malignancies will reduce the time of examination of patients and prescribe antitumor treatment earlier.