Clinical value of endobronchial ultrasound elastography in the differential diagnosis of benign and malignant hilar and mediastinal lymph nodes in patients with lung cancer
Objective To investigate the clinical application value of endobronchial ultrasound elastography in the differential diagnosis of benign and malignant hilar and mediastinal lymph nodes in patients with lung cancer.Methods A total of 87 patients with suspected lung cancer from our hospital were selected.And a total of 147 lymph nodes were examined by ultrasound-guided transbronchial needle aspiration,which confirmed 56 benign and 91 malignant lymph nodes.The shape,maximum diameter,echo type,internal echo distribution,and edge clarity of lymph nodes were observed by two-dimensional ultrasound,while the ultrasound elasticity score and strain rate ratio were observed by endobronchial ultrasound elastography.The differences of the results of two-dimensional ultrasound and endobronchial ultrasound elastography between benign and malignant lymph nodes were compared.Receiver operating characteristics(ROC)curve was drawn to analyze the diagnostic efficacy of two-dimensional sonographic features,quantitative parameters,and endobronchial ultrasound elastographic parameters in the differential diagnosis of benign and malignant hilar and mediastinal lymph nodes in patients with lung cancer.Results Two-dimensional ultrasound showed that there were significant differences in maximum diameter,shape,echo type,internal echo distribution,and margin clarity between benign and malignant lymph nodes(all P＜0.05).Endobronchial ultrasound elastography showed that the elasticity score of benign and malignant lymph nodes were(1.85±0.97)points and(3.36±0.91)points,respectively,and the strain ratios were 20.62±17.12 and 87.67±49.17,respectively.The difference were statistically significant(both P＜0.001).ROC curve analysis showed that the areas under the curve(AUC)of elasticity score and strain ratio in differentiating benign and malignant hilar and mediastinal lymph nodes in patients with lung cancer were 0.854 and 0.931,respectively.The difference was statistically significant(P＜0.05),which were higher than AUC of two-dimensional sonographic features and quantitative parameters(all P＜0.05).Conclusion Endobronchial ultrasound elastography can effectively distinguish benign and malignant hilar and mediastinal lymph nodes in lung cancer patients,demonstrating good clinical application value.
Ultrasonography,endobronchialElastographyLung cancerMediastinal lymph nodes,benign and malignant
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