经皮肺抽吸活检对晚期癌症病人合并肺部疑难病变的诊断价值

目的:探讨经皮肺穿吸活检对晚期癌症患者合并肺实质疑难病变的诊断价值.方法:对51例晚期肺外恶性肿瘤合并肺部实质性病变且诊断有疑难的患者,行经皮肺穿刺抽吸活检术,抽吸物联合进行病理细胞学检查、细菌学培养、抗酸染色检查以明确诊断.结果:51例肺抽吸组织病理学诊断为炎症19例(37.25％)、恶性肿瘤14例(27.45％)、真菌感染8例(15.69％)、结核4例(7.84％)、纤维组织增生3例(5.88％)、无阳性发现3例(5.88％),总阳性率为94.12％ (48/51).病原学检查共检出抗酸染色阳性2例、培养出细菌13例、真菌10例,阳性率分别为3.92％ (2/51)、25.49％(13/51)和19.61％(10/51).结论:经皮肺穿刺抽吸活检术,对抽吸物联合进行病理细胞学、细菌学检查具有较高的检出阳性率,对晚期癌症合并肺部疑难病变患者具有较高的诊断价值.

Diagnostic value of CT-guided percutaneous lung biopsy for the advanced cancer patients with pulmonary lesion

Objective:To evaluate the diagnostic value of CT-guided percutaneous lung biopsy for the advanced cancer patients with pulmonary lesion.Methods:CT-guided percutaneous lung biopsy was performed in 51 cases of advanced lung cancer complicated with pulmonary parenchymal lesions of difficult diagnosis.The aspirates were treated by pathocytology bacteriological culture and acid fast staining examination to confirm the diagnosis.Results:Of the 51 cases,the inspection result suggested 19 cases of inflammation (37.25％),14 cases of malignant tumor (27.45％),8 cases of fungi infection (15.69％),4 cases of tuberculosis infection (7.84％),3 cases of fibrous tissue hyperplasia (5.88％),and 3 cases of no positive result (5.88％).The total positive rate was 94.12％ (48/51).Pathogenic examination suggested 2 cases with positive acid-fast staining,13 cases with bacteria infection,10 cases with fungi infection.The positive rate were 3.92％ (2/51),25.49％ (13/51) and 19.61％ (10/51) respectively.Conclusion:Percutaneous lung biopsy followed by pathocytology bacteriological culture and acid fast staining examinations showed high positive detection rate,which suggested a role in the lung cancer complicated with pulmonary parenchymal lesions.