MSCT引导下穿刺活检早期诊断肺癌的临床应用价值  

Value of MSCT-guided biopsy in the early diagnosis of lung cancer

作　　者：李捷[1,2] 张紫寅[3,4] 王宏[1,2] 何志明[1,2] 王利民[1,2] 唐建建[4] 

机构地区：[1]四川绵阳四〇四医院 [2]川北医学院附属第二医院放射科,四川绵阳621000 [3]四川大学华西医院放射介入室,四川成都610041 [4]海南医学院附属医院神经外科,海南海口570102

出　　处：《海南医学》2013年第15期2250-2252,共3页Hainan Medical Journal

基　　金：国家"十一五"重大科技专项(编号:2009zx1004-905)

摘　　要：目的观察多层螺旋CT（Multi．slicespiralCT，MSCT）检查及其引导下穿刺肺活检在早期肺癌诊断中的作用及临床意义。方法收集2009年3月至2012年2月本院胸外科及肿瘤科收治的80例可疑为肺癌患者的临床资料，其中男性52例，女性28例，年龄35～72岁，平均59岁。80例患者均行MSCT检查及穿刺肺活检，统计各项检查结果及穿刺后并发症，以外科手术后病理检查结果作为诊断的金标准。结果MSCT检查发现1．5-3．0mm结节24例，3．0-6．0mm结节45例，6．0～14mm结节11例。MSCT引导下肺活检穿刺病理诊断结果癌症率为93．75％（75／80例），术后肺组织病理检测出癌症率为98．75％（79／80例），均是早期肺癌，无淋巴结转移；MSCT引导下肺活检穿刺诊断早期肺癌的灵敏度为94．94％，特异度为80．45％。术后并发气胸者12例（15％），局部少量出血者5例（6．25％），穿刺后发生局部肺感染者3例（3．75％），无造成肿瘤播散或者种植患者。结论MSCT引导下肺穿活检术结合病理检查，检出小直径肺癌的灵敏度高、特异性好，可以明显提高早期肺癌诊断率。Objective To observe the role and clinical significance of multi-slice spiral CT （MSCT） and MSCT-guided biopsy in the early diagnosis of lung cancer. Methods The clinical data of 80 patients who were diag- nosed as lung cancer suspiciously in the Department of Thoracic Surgery and Oncology from March 2009 to February 2012 was collected. There were 52 males and 28 females, aged from 35 to 72 years old, with an average age of 59 years old. All the 80 patients underwent MSCT examination and MSCT-guided lung biopsy, and the results of histo- pathologic and complications were recorded. Histopathologic examinations after surgery were considered as the gold- en standard for the fmal diagnosis. Results There were 80 cases of nodules by MSCT, including 24 cases of 1.5-3.0 mm, 45 cases of 3.0 and 11 cases of 6.0-14 mm nodules. Lung cancers diagnosed by MSCT-guided biopsy were 75 cases （93.75%）, however the postoperative histopathologic examinations showed 79 cases （98.75%） were lung cancers in early stage without lymph node metastasis. The sensitivity and specificity of early diagnosis of lung cancer by MSCT-guided biopsy were 94.92% and 80.45%, respectively. Pneumothorax occurred in 12 cases （15%）, bleeding oc- curred in 5 cases （6.25%）, and infections of partial lung occurred in 3 patients （3.75%）. No patients suffered tumor spreading or planting after lung puncture. Conclusion MSCT-guided lung biopsy combined with pathological exami- nations could significantly improve the ratio of early diagnosis of lung cancers with remarkable sensitivity and speci- ficity, especially in the detection of small diameter nodules.

关 键 词：MSCT 活检 肺癌 早期 

分 类 号：R734.2[医药卫生—肿瘤]