CT引导下经皮肺穿刺活检对肺周围性病变的诊断价值分析

Value analysis of CT guided percutaneous lung biopsy for the diagnosis of peripheral pulmonary lesions

目的研究CT引导下经皮肺穿刺活检(CT-GPLB)对肺周围性病变的诊断价值。方法对269例肺周围性病变患者进行CT引导下经皮肺穿刺活检,并对活检组织行病理学检查和(或)组织培养,观察活检结果及并发症发生情况。结果 269例患者中,有268例取得病理组织, 263例获得明确诊断,其中恶性病变173例,包括鳞癌24例,腺癌110例,腺鳞癌3例,小细胞癌14例,浸润性癌8例,肺淋巴上皮瘤样癌1例,肺外转移瘤11例,肺肉瘤2例;良性病变90例,包括结核29例,炎性病变35例,隐球菌8例,肺炎性结节4例,软骨瘤3例,肺组织胞浆病2例,肺良性间叶瘤1例,间质性肺炎1例,干燥综合征1例,慢性肉芽肿性炎1例,韦格氏肉芽肿1例,毛霉菌1例,曲霉菌1例,毛霉菌、曲霉菌1例,肺炎性假瘤1例;5例未能明确诊断。气胸发生率为10.0%(27/269),咯血发生率为7.1%(19/269),经对症处理后均缓解。结论 CT引导下经皮肺穿刺活检应用在肺周围性病变诊断中的准确率较高,并发症较少,是一种安全有效的诊断方式,临床应用价值高。

Objective To study the value of CT guided percutaneous lung biopsy for the diagnosis of peripheral pulmonary lesions.Methods CT-guided percutaneous lung biopsy was performed in 269 patients with peripheral pulmonary lesions.Pathological examination and/or tissue culture were performed to observe the results of biopsy and the occurrence of complications.Results Of the 269 cases,the pathological tissue of 268 cases was collected,and 263 cases were definitely diagnosed,including 173 malignant cases,of which there were 24 cases of squamous cell carcinoma,110 cases of adenocarcinoma,3 cases of adenosquamous carcinoma,14 cases of small cell carcinoma,8 cases of invasive carcinoma,1 case of pulmonary lymphoid epithelioid carcinoma,and 11 cases of extrapulmonary metastases,2 cases of pulmonary sarcoma,90 benign cases,of which there were 29 cases of tuberculosis,35 cases of inflammatory disease,8 cases of cryptococcus,4 cases of pneumonia nodules,3 cases of chondroma,2 cases of pulmonary tissue cytoplasm,1 case of benign mesenchymal carcinoma,1 case of interstitial pneumonia 1 case of Sjogren’s syndrome,1 case of chronic granulomatous inflammation,1 case of Weg’s granuloma,1 case of Mucor,1 case of Aspergillus,1 case of Mucor,Aspergillus,1 case of pneumonia and 5 cases were not definitely diagnosed.The incidence of pneumothorax was 10.0%(27/269)and hemoptysis was 7.1%(19/269),and both alleviated after symptomatic treatment.Conclusion CT guided percutaneous lung biopsy shows high accuracy for the diagnosis of peripheral pulmonary lesions with less complications.It is a safe and effective diagnostic method and contains high clinical application value.