CT引导下经皮穿刺活检食管占位性病变的有效性及安全性

Efficacy and safety of CT-guided percutaneous biopsy of esophageal space-occupying lesions

目的 观察CT引导下经皮穿刺活检食管占位性病变的有效性及安全性。方法 回顾性分析37例接受CT引导下经皮穿刺活检的食管占位性病变患者(37个病灶),统计取材成功率、穿刺病理诊断率及诊断准确率(以术后病理诊断或随访诊断为最终诊断)和术中、术后并发症。结果 37个病灶均穿刺取材成功并获明确病理诊断,32个病理结果为阳性(肿瘤性病变)、5个为阴性(炎性病变或正常组织),穿刺病理诊断率100%。32个阳性病变穿刺病理诊断与最终诊断结果均一致;5个穿刺阴性病变中,3个与最终诊断一致,2个术后病理均为胃肠间质瘤,穿刺诊断准确率为94.59%(35/37),假阴性率40.00%(2/5)。术后2例出现少量气胸、3例穿刺针道少量出血,1周后均自然吸收,并发症发生率13.51%(5/37)。结论 CT引导下经皮穿刺食管占位性病变安全、有效。

Objective To observe the efficacy and safety of CT-guided percutaneous biopsy of esophageal space-occupying lesions. Methods Data of 37 patients with esophageal space-occupying lesion(37 lesions) retrospectively reviewed. All patients underwent CT-guided percutaneous puncture biopsy. The success rate of sampling, the pathological diagnosis rate and the diagnostic accuracy rate of puncture(taken the postoperative pathological diagnosis or follow-up diagnosis as the final diagnosis), as well as the intraoperative and postoperative complications were analyzed. Results The lesions were successfully punctured, and pathological diagnosis was confirmed in all 37 cases, including 32 positive(neoplastic lesions) and 5 negative(inflammatory lesions or normal tissues), and the pathological diagnostic rate of puncture was 100%. The puncture diagnosis was consistent with final diagnosis in all 32 puncture-positive lesions. Among 5 puncture-negative lesions, the puncture diagnosis was consistent with final diagnosis 3 lesions, while postoperative pathology diagnosis was gastrointestinal stromal tumors in the rest 2 cases. The diagnostic accuracy of puncture was 94.59%(35/37), and the false-negative rate of puncture was 40.00%(2/5). A small amount of pneumothorax occurred in 2 cases, while puncture needle bleeding happened in 3 cases, which naturally absorbed during 1 week. The complication incidence of puncture was 13.51%(5/37). Conclusion CT-guided percutaneous biopsy of esophageal space-occupying lesions was safe and effective.