AUTHOR=Hu Tingting , Li Yishi , Wang Xiaohui , Chen Yan , Nie Xiao , Zhuang Rongjuan , Li Ying , Guo Shuliang 

TITLE=Early and Regular Bronchoscopy Examination on Effect of Diagnosis and Prognosis for Patients With Tracheobronchial Tuberculosis

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.825736

DOI=10.3389/fmed.2022.825736

ISSN=2296-858X

ABSTRACT=Abstract
Background: Bronchoscopy is the main method for diagnosis of tracheobronchial tuberculosis (TBTB). But it is not well used in patients with pulmonary tuberculosis (PTB), leading to missed diagnosis. The aim of study is to verify the value and feasibility of bronchoscopy for early diagnosis and treatment of TBTB.

Materials and methods: A prospective observational study was performed in patients with active PTB. The ratios of TBTB and tracheobronchial stenosis were analyzed with propensity score matching (PSM) for baseline characteristics, Cox regression model was further employed to adjust for residual confounding factors.

Results: A total of 656 patients with active PTB were enrolled in the study, including 307 in active group and 349 in non-active group. The ratio of TBTB was significantly higher in active group than that in non-active group (HR, 2.31; 95% CI, 1.70-3.14; p＜0.001). With PSM, the proportion of tracheobronchial stenosis in non-active group was significantly higher than that in active group (HR, 1.84; 95% CI, 1.15-2.95; p=0.011). Moreover, the number of patients with moderate to severe stenosis were also significantly higher than that in active group (HR, 4.13; 95% CI, 2.25-7.63; p＜0.001). Similar results were obtained with multivariate analysis. With 12 months of treatment, both therapeutic effective rate (84.7% vs. 68.2%; p=0.009) and improvement rate of non-fibrotic tracheobronchial stenosis (79.1% vs. 47.4%; p=0.022) were higher in active group than that in non-active group.

Conclusion: Active and regular bronchoscopy is conducive to early diagnosis of TBTB, combined with prompt anti-tuberculosis therapy, greatly reducing the occurrence of tracheobronchial stenosis and improving prognosis.

Keywords: Tracheobronchial tuberculosis, Bronchoscopy, Early diagnosis, Treatment, Tracheobronchial stenosis

Clinical Trial Registration: Registrar: Guo, Shuliang; website: http://www.chictr.org.cn; registration number: ChiCTR1900023525.