经皮CT引导下切割针肺活检假阴性结果分析

Analysis of False-Negative Results of Percutaneous CT-Guided Cutting Needle Lung Biopsy

目的 通过分析经皮CT引导下切割针肺活检(CNB)非特异性良性活检结果患者的各项资料,以明确假阴性结果的预测因素。方法 回顾性分析首次接受CNB且活检结果为非特异性良性的患者,并根据最终诊断结果将患者分为真阴性组(TN)和假阴性组(FN)。比较两组患者的人口学资料、临床资料、影像资料及活检程序资料,明确假阴性结果的影响因素。结果 在纳入分析的263例中,205例最终证实为良性病变,58例最终证实为恶性病变,非特异性良性病变的阴性预测值(NPV)为77.9%。在多因素Logistic回归分析中,患者的年龄大(P=0.004)、亚实性病变(P=0.022)及调针次数多(P=0.017)是假阴性结果的重要预测因素。结论 高龄患者、亚实性病变及多次调针与假阴性的发生显著相关,当此类情况发生时,应采取进一步措施明确是否为假阴性,提高临床诊疗效率。

Objective To clarify the predictive factors of false negative results by analyzing various data of patients with non specific benign biopsy results of percutaneous CT guided cutting needle lung biopsy(CNB). Methods Patients who underwent CNB for the first time with nonspecific benign biopsy results were retrospectively analyzed, and patients were divided into a true negative group(TN) and a false negative group(FN) according to the final diagnosis.The demographic data, clinical data, imaging data and biopsy procedure data of the two groups were compared to clarify the factors influencing the false negative results. Results Of the 263 cases included in the analysis, 205 were eventually confirmed as benign lesions and 58 were eventually confirmed as malignant lesions, with a negative predictive value(NPV) of 77.9% for nonspecific benign lesions.In multifactorial logistic regression analysis, older age of the patients(P=0.004),subsolid lesions(P=0.022) and high number of needle transfers(P=0.017) were significant predictors of false negative results. Conclusion Advanced age, subsolid lesions and multiple needle transfers are significantly associated with the occurrence of false negatives, and when such cases occur, further measures should be taken to clarify whether they are false negatives and to improve clinical efficiency.