中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2012年
4期
346-348
,共3页
陈晋峰%刘轶男%吴楠%冯源%王嘉%吕超%王宇昭%裴宇权%阎石%郑庆锋%张力建%杨跃
陳晉峰%劉軼男%吳楠%馮源%王嘉%呂超%王宇昭%裴宇權%閻石%鄭慶鋒%張力建%楊躍
진진봉%류질남%오남%풍원%왕가%려초%왕우소%배우권%염석%정경봉%장력건%양약
肺肿瘤%胸腔镜手术,电视辅助%活组织检查,针吸
肺腫瘤%胸腔鏡手術,電視輔助%活組織檢查,針吸
폐종류%흉강경수술,전시보조%활조직검사,침흡
Lung neoplasms%Thoracic surgery,video-assisted%Biopsy,needle
目的 明确术中对肺内肿物进行穿刺冰冻病理检查的优缺点、注意事项,及其是否可以代替肿物切除活检.方法 选取2010年1-10月间50例肺内肿物患者,男性28例,女性22例；年龄41～ 77岁,平均年龄59岁.影像学检查为肺内单发结节.在开胸手术或胸腔镜手术下,细针穿刺肿瘤进行术中冰冻病理检查.记录穿刺过程中的并发症,所有的切除标本术后行石蜡病理检查,以确定肿瘤的病理性质.分析术中冰冻病理检查与术后石蜡病理检查之间的关联度.结果 本组患者的肿瘤大小为1.0 cm×0.6 cm～5.6 cm ×9.0 cm.以术后石蜡病理诊断为金标准,最终确诊良性肿瘤7例,恶性肿瘤43例.术中穿刺活检诊断的灵敏度为90.7％,特异度为100％,阳性预测值为100％；阴性预测值为63.6％.11例术中穿刺诊断为良性的患者中,有4例术后石蜡病理诊断为恶性肿瘤,假阴性率为9.3％.术中穿刺活检的主要并发症为穿刺过程中损伤肿瘤周围血管,造成穿刺点出血,发生率为4.0％ (2/50).结论 术中穿刺肿瘤进行冰冻病理检查的特异度较高,但有一定的假阴性率；术中穿刺活检可以在一定程度上替代术中肿物的切除活检.
目的 明確術中對肺內腫物進行穿刺冰凍病理檢查的優缺點、註意事項,及其是否可以代替腫物切除活檢.方法 選取2010年1-10月間50例肺內腫物患者,男性28例,女性22例；年齡41～ 77歲,平均年齡59歲.影像學檢查為肺內單髮結節.在開胸手術或胸腔鏡手術下,細針穿刺腫瘤進行術中冰凍病理檢查.記錄穿刺過程中的併髮癥,所有的切除標本術後行石蠟病理檢查,以確定腫瘤的病理性質.分析術中冰凍病理檢查與術後石蠟病理檢查之間的關聯度.結果 本組患者的腫瘤大小為1.0 cm×0.6 cm～5.6 cm ×9.0 cm.以術後石蠟病理診斷為金標準,最終確診良性腫瘤7例,噁性腫瘤43例.術中穿刺活檢診斷的靈敏度為90.7％,特異度為100％,暘性預測值為100％；陰性預測值為63.6％.11例術中穿刺診斷為良性的患者中,有4例術後石蠟病理診斷為噁性腫瘤,假陰性率為9.3％.術中穿刺活檢的主要併髮癥為穿刺過程中損傷腫瘤週圍血管,造成穿刺點齣血,髮生率為4.0％ (2/50).結論 術中穿刺腫瘤進行冰凍病理檢查的特異度較高,但有一定的假陰性率；術中穿刺活檢可以在一定程度上替代術中腫物的切除活檢.
목적 명학술중대폐내종물진행천자빙동병리검사적우결점、주의사항,급기시부가이대체종물절제활검.방법 선취2010년1-10월간50례폐내종물환자,남성28례,녀성22례；년령41～ 77세,평균년령59세.영상학검사위폐내단발결절.재개흉수술혹흉강경수술하,세침천자종류진행술중빙동병리검사.기록천자과정중적병발증,소유적절제표본술후행석사병리검사,이학정종류적병이성질.분석술중빙동병리검사여술후석사병리검사지간적관련도.결과 본조환자적종류대소위1.0 cm×0.6 cm～5.6 cm ×9.0 cm.이술후석사병리진단위금표준,최종학진량성종류7례,악성종류43례.술중천자활검진단적령민도위90.7％,특이도위100％,양성예측치위100％；음성예측치위63.6％.11례술중천자진단위량성적환자중,유4례술후석사병리진단위악성종류,가음성솔위9.3％.술중천자활검적주요병발증위천자과정중손상종류주위혈관,조성천자점출혈,발생솔위4.0％ (2/50).결론 술중천자종류진행빙동병리검사적특이도교고,단유일정적가음성솔；술중천자활검가이재일정정도상체대술중종물적절제활검.
Objective To investigate the diagnostic accuracy of needle puncture biopsy and pathological examination of frozen during operation for pulmonary nodules,and whether this diagnostic method can replace tumor resection examination.Methods Totally 50 patients (28 males and 22 females,average age was 59 years ) who had the single nodule after imaging examination without any pathological diagnostic from January to October 2010 were selected in this research work.During open operation or video assisted thoracic surgery,needle ( 14 G model) was used to puncture biopsy for pathological examination of frozen.All the adverse events during puncture biopsy would be recorded.The resection specimens would be accepted paraffin pathological examination. The relationship between puncture frozen pathological and paraffin pathological examination was analyzed.Results All tumor sizes were ranged from 1.0 cm × 0.6 cm to 5.6 cm × 9.0 cm.The paraffin pathological examination after operation as the golden standard,there were 7 cases of benign tumor and 43 cases of malignant tumor.The diagnostic sensitibility of puncture biopsy was 90.7％,the specificity was 100％,the positive predictive value was 100％ and the negative predictive value was 63.6％.There were 11 cases of benign tumor diagnosed by needle puncture biopsy,among which 4cases were proved as malignant tumor by paraffin pathology,and the false negative rate was 9.3％.The main risk of puncture biopsy was bleeding after puncture immediately,and the rate was 4.0％ (2/50).Conclusions The puncture hiopsy during operation had a high specificity for malignant lung tumor,and there was a certain false negative rate for benign tumor.Puncture biopsy and pathological examination of frozen tissue can replace tumor section biopsy in a way.
