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内容記述 |
Background: The: American Thoracic Society’s guideline of nontuberculous mycobacteria associated: pulmonary disease (NTM PD) suggests bronchoscopy as one of the ways to detect: nontuberculous mycobacterium ( However, the guideline also acknowledges that l imited: data are available on the utility of bronchoscope for the diagnosis of NTM PD. The purpose of: this study was to elucidate the diagnostic yield of bronchoscopy for patients suspected for NTM: PD when sputum cannot reveal NTM. At the same time, we eval uated factors that affected the: results of bronchoscopy. Furthermore, we estimated the specificity of bronchoscopy for detecting: NTM.: Method: This: study utilized a retrospective cohort study design based on the review of medical records: and was conducted at St Luke’s International Hospital in Tokyo, Japan. Between January 1,: 2004 and June 30, 2018, among all adult patients who underwent bronchoscopy, two groups: were enrolled. Group A included all patients with nodular bronchiectasis pattern on chest: comp uted tomography ( findings who could not produce culture positive sputum for NTM: and therefore underwent bronchoscopy for the diagnoses of NTM PD. Group B comprised of: patients who received bronchoscopy suspected for lung cancer. Group A was used to eva luate: diagnostic yield of NTM PD using bronchoscopy, and group B was employed to measure: specificity of bronchoscopy.: Result: Diagnostic: yield of bronchoscopy for NTM PD was 114/205 ( 99 were patients of: pulmonary MAC, remainder were 10 patients of N TM other than MAC, and 5 patients oftuberculosis.: Logistic regression showed 4 factors associated with NTM PD: examination of the: upper lobe (odds ratio [ 2.31, 95% confidence interval [ 1.21 4.55), absence of: particular bacteria ( 3.35, 95% CI 1.44 8.30), absence of connective tissue disease (: 3.17, 95% CI: 1.25 8.79), and higher total CT scores ( 1.14, 95% CI: 1.03 1.27) Specificity: of bronchoscopy for NTM PD was 99.2% (900/: Conclusion: Bronchoscopy: showed moderate diagnostic yie ld and high specificity for NTM PD. |
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論文要旨 (313.4 kB)
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