自动活检枪经皮肺穿刺活检在晚期肺癌病理学诊断中的应用

Percutaneous transthoracic Bard biopsy instrument in pathologic diagnosis for advanced lung cancer

目的探讨CT导向下巴德活检枪经皮肺穿刺活检在晚期肺癌病理学诊断中的临床应用价值。方法对经胸部螺旋CT检查临床诊断为Ⅲa-Ⅳ期肺癌，行痰细胞学和纤维支气管镜等检查，未能获得病理诊断的35例患者，施行巴德活检枪经皮肺穿刺肺内病灶组织活检术。结果35例患者中33例经巴德自动穿刺活检枪活检术后取得病理学标本，成功率为94％；术后病理诊断为肺癌31例，其中腺癌20例，鳞癌9例，肺泡癌1例，小细胞肺癌1例；炎性假瘤1例，未能明确诊断1例。2例发生气胸，1例出现少量咯血。结论对常规检查方法不能明确病理诊断的晚期肺癌患者，巴德活检枪经皮肺穿刺活检术可作为一种有效的确诊手段。

Objective To study the clinical application of Bard disposable biopsy instrument in the pathologic diagnosis for advanced lung cancer. Methods Thirty - five patients were dignosed as having advanced lung cancer staged Ⅲa - IV by chest X -ray, computed tomography, for which a pathologic diagnosis was not made by sputum and bronchoscopie examination. CT - guided Bard disposable biopsy instrument percutaneous transthoracic biopsy was performed in order to obtain the pathology diagnosis of pulmonary lesions. Results Pathologic samples were obtained in 33 of the 35 patients by Bard disposable biopsy instrument percutaneous transthoracis biopsy. The successful rate was 94% , After operation, the pathologic diagnosis was confirmed to be lung cancer in 31 patients. Adenocarcinoma was found in 20 patients, squamous carcinoma in 9, alveolar cell carcinoma in 1 and small cell lung cancer in 1. Inflammatory pseudotumor in 1,1 case was not clear. Pneumothorax and mild haemoptysis occurred in 2 patients and 1 of the case respectively. Conclusion Bard disposable biopsy instrument percutaneous transthoracic biopsy is an effective diagnostic measure for patients with advanced lung cancer for which pathologic diagnosis is not determined by routine examinations.