Clinical application of electromagnetic navigation bronchoscopy-assisted preoperative localization of pulmonary nodules in HIV-infected/AIDS patients

doi:10.19871/j.cnki.xfcrbzz.2025.06.008

Abstract

Abstract: Objective To analyze the clinical data of HIV-infected/AIDS patients undergoing preoperative localization of pulmonary nodules with electromagnetic navigation bronchoscopy, summarize its safety and efficacy, and provide evidence for promoting this technique among HIV-infected/AIDS populations. Method A retrospective study included patients with pulmonary nodules and HIV infection/AIDS who visited Chengdu Public Health Clinical Medical Center from September 2023 to December 2024. All patients underwent electromagnetic navigation bronchoscopy-assisted preoperative localization of pulmonary nodules followed by fluorescence-guided thoracoscopic surgery. Baseline data, surgical outcomes, nodule location, density, pathological results, and surgical approaches were collected for statistical description and analysis. Result This study included 17 patients with pulmonary nodules and HIV infection/AIDS. Among them, 8 patients had solitary pulmonary nodules, 8 had unilateral multiple nodules, and 1 had bilateral multiple nodules. A total of 28 pulmonary nodules were preoperatively localized using electromagnetic navigation bronchoscopy, with an average size of (7.61±3.16) mm. In terms of anatomical distribution, there were 11 nodules (39.29%) in the right upper lobe, 3 nodules (10.71%) in the right middle lobe, 6 nodules (21.43%) in the right lower lobe, 6 nodules (21.43%) in the left upper lobe, and 2 nodules (7.14%) in the left lower lobe.In terms of pathological classification of nodules, there were 10 pure ground-glass nodules (35.71%), 14 mixed ground-glass nodules (50.00%), and 4 solid nodules (14.29%). The average distance from the pulmonary nodules to the visceral pleura was (11.41±5.68) mm, and the average procedure duration was (21.29±5.49) min. The localization success rate was 96.4% (27/28), with no related complications occurring. Postoperative pathological results showed that among the 28 preoperatively localized nodules from 17 patients, there were 2 cases of adenocarcinoma in situ (7.14%), 10 cases of minimally invasive adenocarcinoma (35.71%), 3 cases of invasive adenocarcinoma (10.71%), 3 cases of granuloma (10.71%), and 10 cases of inflammatory nodule (35.71%). Conclusion In patients with pulmonary nodules complicated by HIV infection/AIDS, electromagnetic navigation bronchoscopy-assisted preoperative localization of pulmonary nodules offers rapid, safe, and effective positioning while reducing occupational exposure risks for operators. It provides an optimal preoperative localization strategy for this special population and merits clinical promotion and application.

Key words: Pulmonary nodules, HIV infection, AIDS, Preoperative localization, Electromagnetic navigation bronchoscopy

CLC Number:

R511
R655.3

Gong Sheng, Li Dan, Wang Ning, Li Gang, Liu Yu, Jiang Liangshuang, Yao Xiaojun. Clinical application of electromagnetic navigation bronchoscopy-assisted preoperative localization of pulmonary nodules in HIV-infected/AIDS patients[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(6): 52-56.

References

[1] XIN N, WU XY, CHEN ZH, et al.A new preoperative localiza-tion of pulmonary nodules guided by mixed reality: a pilot study of an animal model[J]. Transl Lung Cancer Res, 2023, 12(1): 150-157.
[2] 崔翔宇, 徐平, 戴锦朝, 等. CT引导下经皮肺穿刺定位在亚肺叶切除术中应用[J]. 青岛大学学报(医学版), 2023, 59(2):287-291.
[3] 程载兴, 梅培圆, 万黎, 等. 电磁导航定位与CT引导下经皮穿刺定位在肺结节手术中应用的系统评价与Meta分析[J]. 中国胸心血管外科临床杂志, 2022, 29(1): 23-29.
[4] SONG JY, SHIN SH, YOO H, et al.Efficacy of combining multi-ple electromagnetic navigation bronchoscopy modalities for diag-nosing lung nodules[J]. J Clin Med, 2022, 11(24): 7341.
[5] CHEN JX, PAN XF, GU CJ, et al.The feasibility of navigation bronchoscopy-guided pulmonary microcoil localization of small pulmonary nodules prior to thoracoscopic surgery[J]. Transl Lung Cancer Res, 2020, 9(6): 2380-2390.
[6] DING HD, SONG N, ZHANG P, et al.Wedge resection plus ade-quate lymph nodes resection is comparable to lobectomy for small-sized non-small cell lung cancer[J]. Front Oncol, 2022, 12: 1022904.
[7] 孟庆华, 张妺, 胡效坤. CT引导下微弹簧圈与Hookwire在肺小结节穿刺定位中的应用比较[J]. 影像研究与医学应用, 2022, 6(2): 179-181.
[8] LU CH, HSIAO CH, CHANG YC, et al.Percutaneous computed tomography-guided coaxial core biopsy for small pulmonary le-sions with ground-glass attenuation[J]. J Thorac Oncol, 2012, 7(1): 143-150.
[9] 焦思杨, 孙云刚, 张强, 等. 肺结节定位并发症的危险因素及列线图预测模型构建[J]. 中国胸心血管外科临床杂志, 2025, 1: 1-6.
[10] NOUR-ELDIN NEA, ALSUBHI M, NAGUIB NN, et al.Risk factor a-nalysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients[J]. Eur J Radiol, 2014, 83(10): 1945-1952.
[11] DOMINGUEZ-KONICKI L, KARAM AR, FURMAN MS, et al.CT-guided biopsy of pulmonary nodules≤10 mm: Diagnostic yield based on nodules' lobar and segmental distribution[J]. Clin Imaging, 2020, 66: 7-9.
[12] 张晓华, 周冰, 李斌, 等. CT 引导下经皮穿刺 Hook-wire 定位肺磨玻璃结节的安全性及有效性研究[J]. 实用放射学杂志, 2022, 38(3): 475-479.
[13] 郑晓东, 聂世威, 周军正, 等. 电磁导航支气管镜引导下肺结节定位和CT引导下Hook-wire穿刺定位在肺癌根治术中的应用效果及安全性比较[J]. 癌症进展, 2024, 22(16): 1814-1817.
[14] 张娟, 史生华, 姜红, 等. 手术相关的HIV职业暴露的危险因素分析及防护管理[J]. 工业卫生与职业病, 2018, 44(4): 314-315.
[15] 姚源山, 项鲁婕, 陈春基, 等. 电磁导航支气管镜辅助下老年多发肺结节患者定位的临床应用[J]. 老年医学与保健, 2024, 30(1): 146-149.
[16] MCWILLIAMS A, TAMMEMAGI MC, MAYO JR, et al.Probability of cancer in pulmonary nodules detected on first screening CT[J]. N Engl J Med, 2013, 369(10): 910-919.
[17] WANG YQ, LIU X, JIA Y, et al.Impact of breathing exercises in subjects with lung cancer undergoing surgical resection: A systematic review and meta-analysis[J]. J Clin Nurs, 2019, 28(5/6): 717-732.
[18] 朱勇, 刘代强, 谢加伟, 等. 1984例HIV感染/AIDS患者抗病毒治疗后的死亡影响因素及列线图预测模型的构建[J]. 中国国境卫生检疫杂志, 2024, 47(6): 636-641.
[19] 王宁, 李刚, 龚胜, 等. 非小细胞肺癌合并HIV感染/AIDS手术患者病理和临床特征及术后并发症影响因素分析[J/CD]. 新发传染病电子杂志, 2024, 9(2): 29-33.
[20] ANDERSEN FD, DEGN KB, RIIS RASMUSSEN T.Electromagnetic navigation bronchoscopy for lung nodule evaluation. Patient selection, diagnostic variables and safety. Clin Respir J, 2020, 14(6): 557-563.
[21] 陈香, 张亚杰, 韩丁培, 等. 电磁导航支气管镜引导下肺结节术前定位183例的单中心临床分析[J]. 中国胸心血管外科临床杂志, 2023, 30(11): 1539-1544.