超声引导穿刺活检对胸膜病变的诊断价值分析

目的探讨和分析超声引导穿刺活检对胸膜病变的诊断价值。 方法回顾性选取浙江省肿瘤医院2010年1月至2017年12月行超声引导胸膜病变穿刺活检、影像及病理资料完整的病例共118例。所有患者均行超声引导下穿刺活检术。以外科手术病理组织学及临床随访结果为"金标准",应用四格表计算超声引导穿刺活检诊断胸膜病变的敏感度、特异度、阳性预测值、阴性预测值和准确性。 结果依据诊断"金标准",118例患者中良性病变17例,恶性病变99例,不确定2例。超声引导胸膜病变穿刺活检病理诊断恶性病变87例,良性病变29例,不确定2例。超声引导穿刺活检诊断胸膜病变的敏感度、特异度、阳性预测值、阴性预测值和准确性分别为87.9%、100.0%、100.0%、58.6%和89.7%。118例患者中4例出现并发症。 结论超声引导胸膜病变穿刺活检术具有实时、操作简便、无放射线危害,以及并发症发生率低等特点,对于胸膜病变具有较高的诊断价值,值得临床推广应用。

Diagnostic value of ultrasound-guided cutting needle biopsy in pleural lesions

ObjectiveTo assess the diagnostic value of ultrasound-guided biopsy for pleural lesions. MethodsA total of 118 cases with complete biopsy, imaging, and pathological data of ultrasound-guided pleural lesions were selected retrospectively from January 2010 to December 2017 at Zhejiang Cancer Hospital. All patients underwent ultrasound-guided biopsy. The surgical pathological histology and clinical follow-up results were used as the "gold standard". The four-table table was used to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound-guided biopsy in the diagnosis of pleural disease. ResultsAccording to the "gold standard" of diagnosis, 17 of 118 patients had benign lesions, 99 had malignant lesions, and 2 had unknown lesions. Based on ultrasound-guided pleural lesion biopsy pathological diagnosis, there were 87 malignant lesions, 29 benign lesions, and 2 unknown lesions. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound-guided biopsy in diagnosis of pleural lesions were 87.9%, 100.0%, 100.0%, 58.6%, and 89.7%, respectively. Complications occurred in 4 of 118 patients. ConclusionUltrasound-guided pleural lesion biopsy has the characteristics of real-time, simple operation, no radiation hazard, and low incidence of complications. It has high diagnostic value for pleural lesions and is worthy of clinical application.