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Lung Cancer |

An Exploratory Research of the Endobronchial Ultrasonography Model to Estimate the Probability of Malignancy in Patients With Peripheral Pulmonary Lesions

Zhengxian Chen*, MD; Hongyan Ren, MS
Author and Funding Information

Guangdong General Hospital, Guangzhou, China


Chest. 2012;142(4_MeetingAbstracts):628A. doi:10.1378/chest.1367058
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Abstract

SESSION TYPE: Lung Cancer Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: To analyze the endobronchial ultarsonographc features of peripheral lung cancer;To screen out the endobronchial ultrasonographic characteristics and establish a model to estimate the probability of maligancy in peripheral pulmonary lesions, and evaluate its clinical diagnostic value.

METHODS: Between September lst 2010 and October 30th 2011, endobronchial ultrasonography(EBUS) were performed in 150 patients with peripheral pulmonary lesions.AT last,The EBUS images of the 135 cases were enrolled, who had a definite dignosis.nine image patterns were issued: the lesion figuration; the continuous hyperechoic margin outside the lesion;the distinct borderline the intemal echo intensity(hyperecho,equal echo or hypoecho); the intemal echo density (homogenicity or heterogenicity) ; air bronchogram (with or without internal hyperechoic dots and linear arcs);concentric circle internal vessels prensence or not; intemal irregular Anechoic area.The clinical characters were included: agegroup(50 years as the cutpoint); current or past smorker; prior diagnosis of malignant tumor; mean serum CEA;location of the lesion.

RESULTS: Through the binary multivariable logistic regression analysis on the 6 independent predictors and by calculating the area under ROC curve,we concluded five charactenstics which contribute to predicting the presence of malignancy: the lesion figuration ; the distinct borderline ; the intemal echo density ; air bronchogram ; intemal irregular echo free area ; agegroup.The equation of malignancy probability for any patient was : P=l/[l+e-Z] Z=(-2.986+1.993X1+1.552X2+l.616X3-2.011X4+1.748X5 +2.296 X6) ( X1 for lesion figuration; X2 for distinct borderline; X3 for the intemal echo density; X4 for air bronchogram; X5 for intemal irregular Anechoic area; X6 for agegroup ,50 years as the cutpoint). This model gave a sensitivity and specificity of 98.7% and 84.5%, accuracy 90.3%.

CONCLUSIONS: Multivariable logistic regression model discriminated between benign and malignant lesions is better than univariable logistic regression. Combined multiple variables predicticting the malignant probability could raise their sensitivity, specificity and accuracy.

CLINICAL IMPLICATIONS: Endobronchial ultrasonography is a safe and practical examination method. It can provide physicians a chance to observe the lesions from inside and discover more information than that obtained through radiology in discriminating peripheral pulmonary lesions.

DISCLOSURE: Zhengxian Chen: Grant monies (from sources other than industry): 50 000 RMB from Guangdong natural fund committee, Grant monies (from sources other than industry): 40000 RMB from Science and Technology Department of Guangdong Province

The following authors have nothing to disclose: Hongyan Ren

No Product/Research Disclosure Information

Guangdong General Hospital, Guangzhou, China

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