近年来,随着肺结节的比例升高,术前经皮肺穿刺活检或经支气管镜活检越来越受到重视。大量临床证据也证实,Ⅰ期非小细胞肺癌(non-small cell lung cancer,NSCLC)的肺穿刺活检是安全可行的。但是,由于肺磨玻璃结节的组织学特点,与实性结...近年来,随着肺结节的比例升高,术前经皮肺穿刺活检或经支气管镜活检越来越受到重视。大量临床证据也证实,Ⅰ期非小细胞肺癌(non-small cell lung cancer,NSCLC)的肺穿刺活检是安全可行的。但是,由于肺磨玻璃结节的组织学特点,与实性结节相比穿刺时更容易发生出血或咳嗽,肿瘤细胞在血流或气流冲击下可能会沿着肺泡壁或针道种植,导致胸膜复发和气腔播散(spread through air spaces,STAS),尤其是胸膜下结节合并有脏层胸膜侵犯和淋巴细胞浸润时需要慎重选择。展开更多
Background Computed tomography （CT）-guided transthoracic lung biopsy is a well-established technique for the diagnosis of pulmonary lesions. The objective of this study was to evaluate the diagnostic efficiency and ...Background Computed tomography （CT）-guided transthoracic lung biopsy is a well-established technique for the diagnosis of pulmonary lesions. The objective of this study was to evaluate the diagnostic efficiency and complication rate of CT-guided lung biopsy in a Chinese population. Methods CT-guided cutting needle lung biopsies were performed in our institution on 1014 patients between January 2000 and October 2010. A chest radiograph was taken after the biopsy. Data about basic patient information, final diagnosis, and complications secondary to biopsy procedure （pneumothorax and bleeding） were extracted. Results The diagnostic efficiency of CT-guided lung biopsy was 94.8%; only 53 patients did not get a final diagnosis from lung biopsy. Final diagnoses found 639 malignant lesions （63.0%） and 322 benign lesions （31.8%）. Pneumothorax occurred in 131 patients and 15 required insertion of an intercostal drain. Small hemoptysis occurred in 41 patients and mild parenchymal hemorrhage occurred in 16 patients. The overall complication rate was 18.5%. Conclusions CT-guided cutting needle biopsy of pulmonary lesions is a relatively safe technique with a high diagnostic accuracy. It can be safely performed in clinical trials.展开更多
Objective To evaluate the complication rate of CT-guided percutaneous lung biopsy and determine the risk factors for complications. MethodsA retrospective investigation of CT-guided percutaneous lung biopsy carried ou...Objective To evaluate the complication rate of CT-guided percutaneous lung biopsy and determine the risk factors for complications. MethodsA retrospective investigation of CT-guided percutaneous lung biopsy carried out between 2002 and 2009 was performed. The risk factors for complications were determined by multivariate analysis of variables related to patient demographics, lung lesions, and biopsy procedures. ResultsA total of 281 biopsy procedures were enrolled. The total complication rate was 55.9% with pneumothorax 32.4% (91/281) and bleeding 34.5% (97/281). The risk factors affecting pneumothorax rate were lesion location, lesion depth, and time of pleural pierce; and the risk factors affecting bleeding complications were lesion depth, lesion size, and age. Predictive models for pneumothorax and bleeding were established by logistic regression. The pneumothorax model had a sensitivity of 80.0% with a specificity of 62.4%,and the bleeding model had a sensitivity of 67.4% with a specificity of 88.8%. ConclusionLesion location, lesion depth, and number of pleural passes were independent risk factors for pneumothorax. Lesion size, lesion depth, and age were independent risk factor for bleeding. The predictive models for pneumothorax and bleeding will helpfully reduce the complication of CT-guided lung biopsy.展开更多
文摘近年来,随着肺结节的比例升高,术前经皮肺穿刺活检或经支气管镜活检越来越受到重视。大量临床证据也证实,Ⅰ期非小细胞肺癌(non-small cell lung cancer,NSCLC)的肺穿刺活检是安全可行的。但是,由于肺磨玻璃结节的组织学特点,与实性结节相比穿刺时更容易发生出血或咳嗽,肿瘤细胞在血流或气流冲击下可能会沿着肺泡壁或针道种植,导致胸膜复发和气腔播散(spread through air spaces,STAS),尤其是胸膜下结节合并有脏层胸膜侵犯和淋巴细胞浸润时需要慎重选择。
文摘Background Computed tomography （CT）-guided transthoracic lung biopsy is a well-established technique for the diagnosis of pulmonary lesions. The objective of this study was to evaluate the diagnostic efficiency and complication rate of CT-guided lung biopsy in a Chinese population. Methods CT-guided cutting needle lung biopsies were performed in our institution on 1014 patients between January 2000 and October 2010. A chest radiograph was taken after the biopsy. Data about basic patient information, final diagnosis, and complications secondary to biopsy procedure （pneumothorax and bleeding） were extracted. Results The diagnostic efficiency of CT-guided lung biopsy was 94.8%; only 53 patients did not get a final diagnosis from lung biopsy. Final diagnoses found 639 malignant lesions （63.0%） and 322 benign lesions （31.8%）. Pneumothorax occurred in 131 patients and 15 required insertion of an intercostal drain. Small hemoptysis occurred in 41 patients and mild parenchymal hemorrhage occurred in 16 patients. The overall complication rate was 18.5%. Conclusions CT-guided cutting needle biopsy of pulmonary lesions is a relatively safe technique with a high diagnostic accuracy. It can be safely performed in clinical trials.
文摘Objective To evaluate the complication rate of CT-guided percutaneous lung biopsy and determine the risk factors for complications. MethodsA retrospective investigation of CT-guided percutaneous lung biopsy carried out between 2002 and 2009 was performed. The risk factors for complications were determined by multivariate analysis of variables related to patient demographics, lung lesions, and biopsy procedures. ResultsA total of 281 biopsy procedures were enrolled. The total complication rate was 55.9% with pneumothorax 32.4% (91/281) and bleeding 34.5% (97/281). The risk factors affecting pneumothorax rate were lesion location, lesion depth, and time of pleural pierce; and the risk factors affecting bleeding complications were lesion depth, lesion size, and age. Predictive models for pneumothorax and bleeding were established by logistic regression. The pneumothorax model had a sensitivity of 80.0% with a specificity of 62.4%,and the bleeding model had a sensitivity of 67.4% with a specificity of 88.8%. ConclusionLesion location, lesion depth, and number of pleural passes were independent risk factors for pneumothorax. Lesion size, lesion depth, and age were independent risk factor for bleeding. The predictive models for pneumothorax and bleeding will helpfully reduce the complication of CT-guided lung biopsy.
