PET/CT引导下肺多发肿瘤穿刺活检的临床诊断价值研究

目的：探讨PET/CT引导下进行肺多发肿瘤穿刺活检的临床诊断价值。 方法：回顾性分析2016年2月至2018年4月我院在PET/CT融合引导下行肺多发肿瘤穿刺活检术的43例患者，根据手术切除病理和长期随访结果，研究PET/CT引导下肺多发肿瘤穿刺活检的临床诊断效果及不良反应。 结果：43例患者经过肺穿刺活检术后均得以病理确诊，穿刺靶病灶准确率100%。43例患者中，肺腺癌19例，鳞癌4例，小细胞癌8例，转移癌9例，良性病变3例。PET/CT引导肺多发肿瘤穿刺活检诊断肺恶性肿瘤的灵敏度为97.5%，特异度为100%，阳性预测值为100%，阴性预测值为75%，诊断准确率为97.7%。肺穿刺术后3例出现中少量气胸，2例肺部少量胸腔积血症状，2例出现少量咳血症状，1例出现术后轻度感染性发热。 结论：PET/CT引导下肺穿刺活检术是一种微创、安全、精准的确诊肺多发肿瘤的有效方法，对提高穿刺活检的准确性、降低假阴性率有一定的临床应用价值。

Study on clinical diagnostic value of puncture biopsy of multiple lung tumors guided by PET/CT

Objective:To investigate the clinical effect of puncture biopsy on multiple lung tumors guided by PET/CT. Methods:The 43 cases of pulmonary multiple tumor biopsy guided by PET/CT fusion in Liuzhou Worker's Hospital between February 2016 and April 2018 were retrospectively reviewed. The clinical effect and adverse reaction of PET/CT-guided puncture biopsy of multiple lung tumors were studied according to the results of surgical resection and long-term follow-up. Results:All 43 patients were confirmed by pathology after lung biopsy, and the accuracy of puncture target lesions was 100%. Among them, 19 cases were adenocarcinoma, 4 cases were squamous carcinoma, 8 cases were small cell carcinoma, 9 cases were metastatic carcinoma, and 3 cases were benign focus. The sensitivity of puncture biopsy of multiple lung malignant tumor guided by PET/CT was 97.5%, specificity was 100%, positive predictive value was 100% and negative predictive value was 75%, diagnostic accuracy was 97.7%. After the lung puncture operation, 3 cases had a small amount of pneumothorax, 2 cases had a small amount of pulmonary bleeding symptoms, 2 cases had a small amount of hemoptysis, and 1 case had postoperatived infectious fever. Conclusions:Lung biopsy guided by PET/CT is a minimally invasive, safe and accurate method for the diagnosis of multiple lung tumors, which has certain clinical value to improve the accuracy of puncture biopsy and reduce the false negative rate.