CT引导肺穿刺组织学与印片细胞学的联合应用

目的评价CT引导下肺穿刺同时行组织学与印片细胞学检查的诊断价值和并发症。方法收集134例CT引导肺部穿刺活检病例作回顾性分析。统计印片细胞学、组织学以及2者结合的敏感性和并发症,并分析其影响因素。结果110例穿刺确诊为恶性肿瘤。穿刺未发现癌细胞者22例,后经手术和随访证实其中假阴性2例。组织学敏感性为82.1%(92/112),印片细胞学敏感性为87.5%(98/112),二者结合敏感性为98.2%(110/112),假阴性率为9.1%(2/22)。气胸发生率为7.5%(10/134),出血、喀血率为11.9%(13/134),仅有2例出血较多,需紧急处理。结论CT引导经皮肺穿刺是敏感性高和安全的定性诊断方法,如同时行组织学及印片细胞学检查,可提高诊断的敏感性,降低假阴性。

The united application of histology and cytology in transthoracic needle biopsy under CT guidance

Objective To evaluate the diagnostic value and complication of transthoracic needle biopsy of thoracic masses and nodules under CT guidance. Methods A total of 134 patients who ander went transthoracic needle biopys under CT guidance were collected. Sensitivity of histology,cytology and two unions, complication and false-negative rate were analyzed. Results Biopsies in 110 cases yielded malignant lesions, carcinoma cells were not found in 22 cases,the remaining 2 cases were found to have false-negative result as the case were proved to be cancer by operation and follow-up later. Sensitivity of histology was 82.1%, sensitivty of cytology was 87.5%,sensitivty of two unions was 98.2%,false-negative rate was 9.1%,pneumothorax occure was 7.5%,bleeding and hemoptysis rate 11.9%, only 2 patients were necessary to be treated . Conclusion CT-guided transthoracic biopsy is a safe and valuable diagnostic method with high sensitivty. If histology and cytology are examined at the same time, sensitivty rate could be raised and false-negative rate could be reduced.