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Autofluorescence imaging-assisted medical thoracoscopy in the diagnosis of malignant pleural disease

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机构: [1]Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China [2]Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China [3]Department of Respiratory and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [4]Department of Respiratory and Critical Care Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China [5]Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China [6]department of respiratory and critical care medicine, Ordos Central Hospital, Ordos Clinical Medical College of Inner Mongolia Medical University, Inner Mongolia, China.
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关键词: Autofluorescence endoscopy Medical thoracoscopy Pleural biopsy Pleural diseases

摘要:
Medical thoracoscopy (MT) does not always provide a conclusive diagnosis of pleural diseases because the endoscopic appearance of pleural diseases can be misleading. Autofluorescence imaging (AFI) is an effective assistive diagnostic tool. However, its clinical application for pleural disease remains controversial.This prospective study evaluated the clinical usefulness of AFI-assisted MT for diagnosis of malignant pleural diseases.Patients with unexplained pleural effusion admitted to our clinics between December 2018 and September 2021 were enrolled. We performed white-light thoracoscopy (WLT) first, and then AFI, during MT. Images of endoscopic real-time lesions were recorded under both modes. Pleural biopsy specimens were analyzed pathologically. Between-groups differences in diagnostic sensitivity, specificity, positive-predictive value (PPV), and negative-predictive value (NPV) were assessed using 95% confidence intervals (CI). Receiver operating characteristic curves and decision curve analyses were employed to analyze the diagnostic efficiency of these two modes.Of 126 eligible patients, 73 cases were diagnosed with malignant pleural disease. A total of 1292 biopsy specimens from 492 pleural sites were examined for pathological changes. The diagnostic sensitivity, PPV, and NPV of AFI were 99.7%, 58.2%, and 99.2%, respectively. AFI was significantly superior to WLT, which had a sensitivity of 79.7%, PPV of 50.7%, and NPV of 62.8%. Subgroup analysis showed that the AFI type III pattern was significantly more specific for pleural malignant disease than that of WLT.AFI could further improve the diagnostic efficacy of MT by providing better visualization, convenience, and safety.Copyright © 2023 Elsevier Ltd. All rights reserved.

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出版当年[2022]版:
大类 | 3 区 医学
小类 | 3 区 呼吸系统 3 区 心脏和心血管系统
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 心脏和心血管系统 3 区 呼吸系统
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出版当年[2021]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Q2 RESPIRATORY SYSTEM
最新[2023]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Q2 RESPIRATORY SYSTEM

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者机构: [1]Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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通讯机构: [1]Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China [*1]Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gong Ti Nan Lu, Chaoyang District, Beijing, 100020, China.
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