经皮肺穿刺和电子气管镜下经支气管肺活检对肺部周围性病变的诊断价值

Diagnostic value of transthoracic needle lung biopsy and transbronchial lung biopsy in peripheral lesions

目的探讨CT引导下经皮肺穿刺和电子气管镜下经支气管两种途径活检对肺部周围性病变的诊断价值。方法根据CT片的病灶位置,近胸壁的肺内病灶,距离胸膜3cm以内,71例行CT引导下经皮肺穿刺活检(TNLB);55例行电子气管镜下经支气管肺活检(TBLB)。结果TNLB和TBLB阳性率分别为81.7%和61.8%(P<0.05);病理诊断符合率分别为97.2%和81.8%(P<0.05);恶性病变的特异性均为100%,敏感性分别为94.0%和83.8%(P>0.05)。TNLB对靠近胸壁的小病灶有较高的阳性率,实验发现大于2cm的病灶和小于2cm的小病灶TBLB活检阳性率有较大的差异。结论TNLB和TBLB对肺部周围性病变的诊断有很重要的价值,两种方法有互补性。合理地选用这两种方法常能获得满意的结果。

[Objective] To evaluate the diagnostic value of CT-guided transthoracic needle lung biopsy（TNLB） and electron tracheoscope-gnided transbronchial lung biopsy （TBLB） in pulmonary peripheral lesions. [Methods] According to the lesion location on CT photo,71 patients were selected with TNLB and 55 with TBLB. [Results] The positive rates of TNLB and TBLB were 81.7% and 61.8%; pathological diagnostic correct rate 97.2% and 81.8%; there was significant difference between the two methods （P 〈0.05）; the peculiarity of malignant lesion 100% respectively; the sensitivity 94.0% and 83.8%; There was higher positive rate with TNLB to small pulmonary nodules by thorax, the positive rates were differences of TBLB between large lesions （diameter 〉2 cm） and small ones （diameter 〈2 cm）. [Conclusion] The two methods are important and complementary to the diagnosis of pulmonary peripheral lesions.