天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2015年
6期
646-648,709
,共4页
李波%王菁%李月川
李波%王菁%李月川
리파%왕정%리월천
癌,非小细胞肺%穿刺术%活组织检查,针吸%外科手术%标本%经皮肺穿刺活检%病理
癌,非小細胞肺%穿刺術%活組織檢查,針吸%外科手術%標本%經皮肺穿刺活檢%病理
암,비소세포폐%천자술%활조직검사,침흡%외과수술%표본%경피폐천자활검%병리
carcinoma,non-small-cell lung%punctures%biopsy,needle%surgical procedures,operative%specimen%per-cutaneous lung biopsy%pathological results
目的：探讨CT引导下经皮肺穿刺活检标本病理结果的可靠性，及其对非小细胞肺癌的诊断价值。方法选择非小细胞肺癌患者91例，影像学检查发现肺部肿物，经痰液细胞学、支气管镜的涂片细胞学或活检组织学等检查，均未能明确诊断的肺部病变患者，后经CT引导下经皮肺内病灶穿刺术，获得涂片细胞学和（或）活检组织学证据，明确诊断为非小细胞肺癌，再行外科手术切除获得完整的病理结果。比较CT引导下经皮肺穿刺活检不同病理类型及不同途径的病理结果与外科手术切除标本的病理结果的差异。结果 CT引导下经皮肺穿刺活检的病理结果与手术结果的符合率为86.81%（79/91）。与手术病理结果比较，经皮肺穿刺活检不同病理类型的符合率差异无统计学意义[鳞癌vs腺癌vs腺鳞癌：88.57%(31/35) vs 86.27%(44/51) vs 80.00%(4/5)，χ2=0.310，P＞0.05]；经皮肺穿刺标本采用不同方法的病理类型结果与手术结果的比较差异有统计学意义（χ2=9.698，P＜0.05），经涂片细胞学+活检组织学获得病理结果的符合率[94.4%(51/54)]高于单独涂片细胞学[60.0%(6/10)]和单独活检组织学[81.4%(22/27)]。结论CT引导下经皮肺穿刺活检对非小细胞肺癌的定性诊断是可靠的，但其病理类型结果可能与手术结果不一致。
目的：探討CT引導下經皮肺穿刺活檢標本病理結果的可靠性，及其對非小細胞肺癌的診斷價值。方法選擇非小細胞肺癌患者91例，影像學檢查髮現肺部腫物，經痰液細胞學、支氣管鏡的塗片細胞學或活檢組織學等檢查，均未能明確診斷的肺部病變患者，後經CT引導下經皮肺內病竈穿刺術，穫得塗片細胞學和（或）活檢組織學證據，明確診斷為非小細胞肺癌，再行外科手術切除穫得完整的病理結果。比較CT引導下經皮肺穿刺活檢不同病理類型及不同途徑的病理結果與外科手術切除標本的病理結果的差異。結果 CT引導下經皮肺穿刺活檢的病理結果與手術結果的符閤率為86.81%（79/91）。與手術病理結果比較，經皮肺穿刺活檢不同病理類型的符閤率差異無統計學意義[鱗癌vs腺癌vs腺鱗癌：88.57%(31/35) vs 86.27%(44/51) vs 80.00%(4/5)，χ2=0.310，P＞0.05]；經皮肺穿刺標本採用不同方法的病理類型結果與手術結果的比較差異有統計學意義（χ2=9.698，P＜0.05），經塗片細胞學+活檢組織學穫得病理結果的符閤率[94.4%(51/54)]高于單獨塗片細胞學[60.0%(6/10)]和單獨活檢組織學[81.4%(22/27)]。結論CT引導下經皮肺穿刺活檢對非小細胞肺癌的定性診斷是可靠的，但其病理類型結果可能與手術結果不一緻。
목적：탐토CT인도하경피폐천자활검표본병리결과적가고성，급기대비소세포폐암적진단개치。방법선택비소세포폐암환자91례，영상학검사발현폐부종물，경담액세포학、지기관경적도편세포학혹활검조직학등검사，균미능명학진단적폐부병변환자，후경CT인도하경피폐내병조천자술，획득도편세포학화（혹）활검조직학증거，명학진단위비소세포폐암，재행외과수술절제획득완정적병리결과。비교CT인도하경피폐천자활검불동병리류형급불동도경적병리결과여외과수술절제표본적병리결과적차이。결과 CT인도하경피폐천자활검적병리결과여수술결과적부합솔위86.81%（79/91）。여수술병리결과비교，경피폐천자활검불동병리류형적부합솔차이무통계학의의[린암vs선암vs선린암：88.57%(31/35) vs 86.27%(44/51) vs 80.00%(4/5)，χ2=0.310，P＞0.05]；경피폐천자표본채용불동방법적병리류형결과여수술결과적비교차이유통계학의의（χ2=9.698，P＜0.05），경도편세포학+활검조직학획득병리결과적부합솔[94.4%(51/54)]고우단독도편세포학[60.0%(6/10)]화단독활검조직학[81.4%(22/27)]。결론CT인도하경피폐천자활검대비소세포폐암적정성진단시가고적，단기병리류형결과가능여수술결과불일치。
Objective To investigate the reliability of CT-guided percutaneous lung biopsy pathological results in diag?nosing Non-small cell lung cancer (NSCLC). Methods Patients (n=91) were selected whose radiology examination re?vealed pulmonary masses but were failed to be confirmed with pulmonary lesion through sputum or bronchoscopy. Then, they were diagnosed as non-small cell lung cancer by CT-guided percutaneous lung biopsy. After that, they received surgical op?eration and biopsies were taken during operations for pathological analysis. Pathological results between from percutaneous lung biopsy (pathological types and using different analysis tools) and from surgical operation were compared. Results The coincidence rate of pathological type is 86.81%(79/91) using pathological results through percutaneous lung biopsy or oper?ation. Compared with the pathological results of operation, the coincidence rate of pathological type using percutaneous lung biopsy show no statistical significance [Squamous cell carcinoma 88.57%(31/35) vs Grandular cell carcinoma 86.27%(44/51) vs adeno-squamous carcinoma 80.00%(4/5),χ2=0.310,P>0.05];the coincidence rate of percutaneous lung biopsy pathologi?cal results using different approaches demonstrate statistical significance compared with surgical biopsy pathological results (χ2=9.698, P<0.05). The coincidence rate of pathological results obtained by Smear and biopsy [94.4%(51/54)] is higher than that of surgical biopsy pathological results using smear alone [60.0%(6/10)] and by biopsy alone [81.4%(22/27)]. Con?clusion Using CT-guided percutaneous lung biopsy, it can produce reliable results on pathological type of non-small cell lung cancer. But the reliability can be affected by different analysis approaches that were hired to exam samples from CT-guided percutaneous lung biopsy.
