超声引导下经皮肺外周病变穿刺活检病理假阴性的影响因素分析

ANALYSIS THE EFFECT PATHOLOGICAL FALSE NEGATIVE OF ULTRASOUND—GUIDED PERCUTANEOUS LUNG BIOPSY IN PERIPHERAL PULMONARY MASSES

目的:分析超声引导下经皮肺外周病变穿刺活检病理假阴性的影响因素。方法:回顾性分析392例经皮肺外周病变穿刺活检患者的病理结果及临床资料,分析患者性别、穿刺进针次数、病灶大小等因素对经皮肺穿外周病变穿刺活检病理假阴性发生的影响。结果:本组穿刺取材成功率98.8%(388/392),病理确诊恶性病变155例,良性病变189例,病理确诊率87.76%(344/392);描述性诊断5.1%(20/392),假阴性6.1%(24/392)。多种因素中,病灶大小对穿刺活检病理假阴性的影响差异有统计学意义(P<0.05);病灶>2cm者,病灶越大假阴性率发生率越高。结论:穿刺活检前详细评估病灶可提高超声引导下肺外周病变穿刺取材成功率。

Objective： To analyze the false negative pathological factors of ultrasound--guided percutaneous lung biopsy in peripheral pulmonary masses. Methods： We analyzed 392 cases of pereutaneous lung biopsy confirmed by pathology or cytology; combined with other pathological findings and clinical data of patients. Gender, the number of puncture needle, the size of the lesion, the factors of the false negative biopsy of the lesions of the skin around the lung were analyzed. Results： Among 392 cases, 155 cases was diagnosed as malignant and 189 lesions as benign, 24 cases of false negative, 20 cases were described diagnosis,the di- agnosis rate of pathological diagnosis of lung peripheral lesions was 87.76% （344/392）. The lesion size had statistically significant effect on the false negative （ P 〈0.05）. Conclusion： Detailed assessment of the lesions before biopsy guided by ultrasound can improve puncture success rate of peripheral pulmonary lesions.