经皮肺穿刺与支气管镜活检对周围性肺癌的诊断价值
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摘要
目的对比经皮肺穿刺与支气管镜活检对周围性肺癌的诊断价值。方法选取2014年6月～2018年7月我院就诊的69例可疑周围肺癌患者,将其随机分为两组,其中皮肺穿刺组30例,支气管镜活检组39例。比较两组患者阳性诊断率、病理诊断符合率、敏感度、特异度及并发症发生情况。结果支气管镜活检组患者病理阳性诊断率79.48%高于皮肺穿刺组63.33%,差异有统计学意义(P<0.05)。支气管镜活检组患者病理诊断符合率、灵敏度、特异度分别为92.31%、91.18%、100%高于皮肺穿刺的72.41%、80.95%、66.67%,差异有统计学意义(P<0.05)。支气管镜活检组患者术后穿刺部位出血5例,气胸1例,咳血3例;皮肺穿刺组术后穿刺部位出血7例,咳血4例,气胸8例,两组间相比,差异有统计学意义(P<0.05)。结论在诊断周围性肺癌支气管镜活检比皮肺穿刺诊断效果更好、并发症发生率低,在临床应用时可优先考虑。
Objective To compare the value of percutaneous lung biopsy and biopsy in the diagnosis of peripheral lung cancer.Methods 69 cases of suspected peripheral pulmonary carcinoma patients in our hospital were randomly divided into two groups,30 cases of percutaneous lung puncture group, 39 cases of bronchoscopic biopsy group. The positive diagnosis rate,pathological diagnosis coincidence rate,sensitivity,specificity and incidence of complications were compared between the two groups. Results The positive rate of biopsy in the bronchial biopsy group was 79.48%higher than that in percutaneous lung puncture group(63.33%),and the difference was statistically significant(P<0.05).The rate of diagnostic accuracy,sensitivity and specificity of bronchoscopic biopsy group was 92.31%,91.18%,100% higher than that of the 72.41%,80.95%,66.67% in percutaneous lung puncture group, respectively,and the difference was statistically significant(P <0.05).In bronchoscopic biopsy group, postoperative bleeding around puncture point in 5 cases,pneumothorax in 1 case,hemoptysis in 3 cases;in percutaneous lung puncture group, there were 7 cases of bleeding around puncture point,4 cases of hemoptysis,8 cases of pneumothorax,with statistically significant differences compared between the two groups(P<0.05).Conclusion Compared with percutaneous lung biopsy,the diagnosis effect of bronchoscopy biopsy was better and the incidence of complications was lower,it will be a priority in clinical application.
Objective To compare the value of percutaneous lung biopsy and biopsy in the diagnosis of peripheral lung cancer.Methods 69 cases of suspected peripheral pulmonary carcinoma patients in our hospital were randomly divided into two groups,30 cases of percutaneous lung puncture group, 39 cases of bronchoscopic biopsy group. The positive diagnosis rate,pathological diagnosis coincidence rate,sensitivity,specificity and incidence of complications were compared between the two groups. Results The positive rate of biopsy in the bronchial biopsy group was 79.48%higher than that in percutaneous lung puncture group(63.33%),and the difference was statistically significant(P<0.05).The rate of diagnostic accuracy,sensitivity and specificity of bronchoscopic biopsy group was 92.31%,91.18%,100% higher than that of the 72.41%,80.95%,66.67% in percutaneous lung puncture group, respectively,and the difference was statistically significant(P <0.05).In bronchoscopic biopsy group, postoperative bleeding around puncture point in 5 cases,pneumothorax in 1 case,hemoptysis in 3 cases;in percutaneous lung puncture group, there were 7 cases of bleeding around puncture point,4 cases of hemoptysis,8 cases of pneumothorax,with statistically significant differences compared between the two groups(P<0.05).Conclusion Compared with percutaneous lung biopsy,the diagnosis effect of bronchoscopy biopsy was better and the incidence of complications was lower,it will be a priority in clinical application.
引文
[1]王昌国,曾大雄,雷伟,等.CT引导下经皮肺穿刺与超声引导下经支气管镜肺活检对肺周围型病变的诊断价值[J].中华结核和呼吸杂志,2015,38(12):16-20.
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[3]Al-Zuhairy A,Schroder HD,Plesner T,et al.Immunostaining of skin biopsy adds no diagnostic value in MGUS-associated peripheral neuropathy[J].Journal of the Neurological Sciences,2015,349(2):60-64.
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[5]Pinsky PF,Parnes HL,Andriole G.Mortality and complications after prostate biopsy in the Prostate,Lung,Colorectal and O-varian Cancer Screening(PLCO)trial[J].Bju International,2014,113(113):254-259.
[6]李凯述,刘明涛,姜淑娟,等.经支气管镜针吸活检联合现场细胞学对肺癌诊断的临床价值[J].中国肺癌杂志,2014,22(3):215-220.
[7]Petranovic M,Gilman MD,Muniappan A,et al.Diagnostic Yield of CT-Guided Percutaneous Transthoracic Needle Biopsy for Diagnosis of Anterior Mediastinal Masses[J].American Journal of Roentgenology,2015,205(4):774-779.
[8]马永强,韩嵩博,杨宁.CT引导经皮肺穿刺活检术对肺门肿块的诊断价值[J].介入放射学杂志,2016,25(3):231-233.
[9]Rutter CE,Corso CD,Park HS,et al.Increase in the use of lung stereotactic body radiotherapy without a preceding biopsy in the United States[J].Lung Cancer,2014,85(3):390-394.
[10]刘卫庭,李再清,肖进国.支气管镜下活检前后吸引对肺癌诊断阳性率的影响[J].中国内镜杂志,2015,21(8):887-889.
[11]Lim E,Brush T,Rogers C.189 VIdeo assisted thoracoscopic lobectomy versus conventional Open LobEcTomy for lung cancer,a multi-centre randomised controlled trial with an internal pilot:the VIOLET study[J].Lung Cancer,2016,6(91):68-69.
[12]王慧,黄礼年.支气管镜介入技术在外周肺病变中的应用[J].中国肺癌杂志,2016,19(8):19-22.
[13]Matsuura K,Kadoya T,Masumoto N,et al.Abstract P5-03-04:The role of lung biopsy in the management of lung nodules in breast cancer patients[J].Cancer Research,2016,75(9):751-761.
[14]莫伟强,官俏兵,邵剑骏,等.彩色多普勒超声引导下经皮肺穿刺活检术老老年疑似Ⅰ~ⅢA期肺癌中的诊断价值[J].中国老年学杂志,2014,17(22):25-29.
[15]Tae-Jung Kim,Chan KP,Chang DY,et al.Simultaneous diagnostic platform of genotyping EGFR,KRAS,and ALK in510 Korean patients with non-small-cell lung cancer highlights significantly higher ALK rearrangement rate in advanced stage[J].Journal of Surgical Oncology,2014,110(3):245-251.
[2]朱然,刘璠,马江伟,等.不同引导方式经皮肺活检对周围型肺癌的诊断价值比较研究[J].中国实用内科杂志,2015,17(1):53-55.
[3]Al-Zuhairy A,Schroder HD,Plesner T,et al.Immunostaining of skin biopsy adds no diagnostic value in MGUS-associated peripheral neuropathy[J].Journal of the Neurological Sciences,2015,349(2):60-64.
[4]刘亚芳,邢舴,宋勇.不同途径获取肺癌组织对病理类型诊断的差异性分析[J].医学研究生学报,2016,29(5):75-77.
[5]Pinsky PF,Parnes HL,Andriole G.Mortality and complications after prostate biopsy in the Prostate,Lung,Colorectal and O-varian Cancer Screening(PLCO)trial[J].Bju International,2014,113(113):254-259.
[6]李凯述,刘明涛,姜淑娟,等.经支气管镜针吸活检联合现场细胞学对肺癌诊断的临床价值[J].中国肺癌杂志,2014,22(3):215-220.
[7]Petranovic M,Gilman MD,Muniappan A,et al.Diagnostic Yield of CT-Guided Percutaneous Transthoracic Needle Biopsy for Diagnosis of Anterior Mediastinal Masses[J].American Journal of Roentgenology,2015,205(4):774-779.
[8]马永强,韩嵩博,杨宁.CT引导经皮肺穿刺活检术对肺门肿块的诊断价值[J].介入放射学杂志,2016,25(3):231-233.
[9]Rutter CE,Corso CD,Park HS,et al.Increase in the use of lung stereotactic body radiotherapy without a preceding biopsy in the United States[J].Lung Cancer,2014,85(3):390-394.
[10]刘卫庭,李再清,肖进国.支气管镜下活检前后吸引对肺癌诊断阳性率的影响[J].中国内镜杂志,2015,21(8):887-889.
[11]Lim E,Brush T,Rogers C.189 VIdeo assisted thoracoscopic lobectomy versus conventional Open LobEcTomy for lung cancer,a multi-centre randomised controlled trial with an internal pilot:the VIOLET study[J].Lung Cancer,2016,6(91):68-69.
[12]王慧,黄礼年.支气管镜介入技术在外周肺病变中的应用[J].中国肺癌杂志,2016,19(8):19-22.
[13]Matsuura K,Kadoya T,Masumoto N,et al.Abstract P5-03-04:The role of lung biopsy in the management of lung nodules in breast cancer patients[J].Cancer Research,2016,75(9):751-761.
[14]莫伟强,官俏兵,邵剑骏,等.彩色多普勒超声引导下经皮肺穿刺活检术老老年疑似Ⅰ~ⅢA期肺癌中的诊断价值[J].中国老年学杂志,2014,17(22):25-29.
[15]Tae-Jung Kim,Chan KP,Chang DY,et al.Simultaneous diagnostic platform of genotyping EGFR,KRAS,and ALK in510 Korean patients with non-small-cell lung cancer highlights significantly higher ALK rearrangement rate in advanced stage[J].Journal of Surgical Oncology,2014,110(3):245-251.