摘要
目的探讨CT引导下经皮肺穿刺活检术(PTNB)诊断非小细胞肺癌(NSCLC)准确率及其影响因素。方法回顾性分析2010年1月1日至2016年11月1日有手术病理结果的NSCLC患者203例,所有患者在术前均行CT引导下PTNB取得组织标本病理。计算穿刺活检诊断准确率,并分析影响穿刺活检诊断准确率的因素。结果 (1)CT引导下PTNB取得的小标本与手术大标本的病理结果符合率为92.6%(188/203);鳞癌和腺癌类型的符合率最高,分别为100%、97.5%,大细胞癌类型的符合率20%。大、小标本对肺腺癌、鳞癌的分型诊断差异无统计学意义(k=0.872、P=0.250)。(2)χ~2检验结果显示观察因素中只有病灶大小是穿刺活检诊断准确率的影响因素(P=0.008)。结论 CT引导下PTNB与手术大标本在NSCLC的诊断方面有较高的符合率,值得在临床推广;病灶大小是穿刺活检诊断准确率的重要影响因素之一。
Objective To investigate the diagnostic accuracy of CT-guided percutaneous transthoracic needle biopsy（PTNB） for non-small cell lung cancer（NSCLC）, and to discuss the factors affecting the diagnostic accuracy of puncture biopsy. Methods The clinical data of a total of 203 patients with pathologically-proved NSCLC, who received CT-guided PTNB during the period from January 1, 2010 to November 1, 2016, were retrospectively analyzed. CT-guided PTNB was performed in all patients before surgery, and tissue specimens were collected for pathological study. The diagnostic accuracy of needle biopsy was calculated, and the factors that might affect the diagnostic accuracy of needle biopsy were analyzed.Results （1）The coincidence rate of pathological results of CT-guided PTNB（small specimens） with surgical specimens（large specimens） was 92.6%（188/203）. The squamous cell carcinoma and adenocarcinoma had the highest coincidence rates, which were 100% and 97.5% respectively. The coincidence rate of large cell carcinoma type was 20%. No statistically significant differences in the coincidence rate of adenocarcinoma and squamous cell carcinoma existed between small specimens and large specimens（k=0.872, P=0.250）.（2）Chi square test showed that only the lesion size was an important factor that affected the diagnostic accuracy of needle biopsy（P =0.008）. Conclusion In diagnosing commonly seen NSCLC, CT-guided PTNB has high coincidence rate with surgical specimens, therefore, CT-guided PTNB is worth popularizing widely in clinical practice. The lesion size is an important factor that affected the diagnostic accuracy of needle biopsy.
出处
《介入放射学杂志》
CSCD
北大核心
2018年第3期274-277,共4页
Journal of Interventional Radiology
关键词
肺
穿刺活检
病理分型
诊断准确率
lung
puncture biopsy
pathological classification
diagnostic accuracy
