To assess the value of endobronchial ultrasound with guide-sheath (EBUS-GS) in the diagnosis of benign and malignant lung diseases.

A retrospective analysis was performed on the clinical data and test results of 154 patients with lung lesions who underwent routine EBUS-GS at the PLA 903 Hospital from January 2018 to June 2019. Using the pathological diagnosis as the gold standard, a four-fold table was used to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-GS in the diagnosis of benign and malignant lung lesions. The χ² test and two-class Logistic regression were used to assess the value of EBUS-GS characteristics in the prediction of malignancy of lung diseases.

Among the 154 patients who underwent EBUS-GS examination, 96 had benign lesions, 54 had malignant lesions, and 4 had lesions whose nature was unclear. According to the gold standard of pathological diagnosis, the accuracy of EBUS-GS was 98.05% (151/154), the consistency rate with the pathology diagnosis was 90.26% (139/154), the sensitivity was 88.42% (84/95), the specificity was 98.15% (53/54), the positive predictive value was 98.82% (84/85), and the negative predictive value was 82.81% (53/64). On EBUS-GS, malignant lesions mostly had an irregular shape, unclear and discontinuous boundary, and basically uniform echo; the interior of the lesions mostly exhibited clumpy-like low echo and some dot-like high echo in the tissue containing gas. In contrast, benign lesions mostly had a regular (round or oval-based) shape, clear and continuous boundary, and mostly uneven echo; the interior of the lesions manily exhibited high echo, with most showing dot or spot-shaped high echo. Logistic regression analysis demonstrated that the acoustic characteristics of EBUS-GS were of some value to predict malignant diseases in the lungs (P＜0.05).

EBUS-GS has appreciated value in the diagnosis of benign and malignant lung diseases, which is helpful for the preliminary evaluation of benign and malignant lung diseases and can provide a new basis for the early clinical diagnosis in the future.