超声引导穿刺活检对中心型肺肿瘤的诊断价值  

The value of ultrasound-guided biopsy in diagnosis of central pulmonary cancer

作　　者：陈敏华[1] 严昆[1] 孙秀明[1] 刘叙仪[2] 李吉友[3] 小川肇[4] 岸本理和[4] 宫坂和男[4] 

机构地区：[1]北京大学临床肿瘤学院超声科,100036 [2]北京大学临床肿瘤学院肿瘤内科,100036 [3]北京大学临床肿瘤学院病理科,100036 [4]日本北海道大学医学部放射线科

出　　处：《中华超声影像学杂志》2001年第8期476-479,共4页Chinese Journal of Ultrasonography

基　　金：北京市科委重点科研项目资助 (95330 790 0 )

摘　　要：目的　对其他检查方法不能作出定性诊断的中心型肺肿瘤进行超声引导穿刺活检 ,探讨该方法对中心型肺肿瘤的诊断价值。方法　通过实变肺行超声检查确认肿瘤 ,并设定穿刺线路。采用 2 1G日产八光手动负压穿刺针摄取组织 ,3 .0cm以上的肿瘤同时加用美国Bard自动活检枪及 2 1G细针活检 ;针腔内残留液均做细胞学检查。结果　 5 2例接受穿刺者组织学检查诊断正确率为 71.2 % ( 37例 ) ,细胞学检查诊断正确率为 6 9.2 %( 36例 ) ,二种方法互补诊断正确率达 84.6 % ( 4 4例 ) ,组织定性诊断率达 80 .8% ( 4 2例 )。并发症 7例 ( 13 .5 % ) ,其中气胸 2例 ,咳血痰 5例 ( 10 % ) ,无严重并发症发生。结论　超声引导细针穿刺活检对肺中心型肿瘤的定性诊断 ,为确定治疗方案提供了依据 ,有较高临床应用价值。但中心型小肿瘤的超声显示和确认仍为穿刺活检的首要条件 。Objective To evaluate the value of ultrasound guided biopsy in diagnosing of those central pulmonary lesions that can't be diagnosed by other examinations.Methods Indentify the tumors in the consolidated lung using ultrasound,and determine the routine of guidance.Perform fine needle biopsy to obtain tissue firstly with 21 gauge needle which contains an outer sheath and an inner stylet (Blakko,Japan).And when the diameter of tumor was larger than 3.0 cm,true cut needles(Bard,American) for biopsy was added to get adequate tissue.The aspiration materials and the remain materials in the true cut needle all underwent a cytologic examination.Results Fifty two cases were included.The accuracy of histologic examination was 71.2% (37 cases),and the accuracy of cytologic examination was 69.2% (36 cases).When these two methods were combined,the accuracy was up to 84.6% (44 cases),and 42 cases( 80.8% ) qot the right pathologic classification.Complications appeared in 7 cases( 13.5% ) including 2 cases pneumothorax,and 5 cases hemoptysis.No serious complication occurred.Conclusions Differentiating diagnosis of the central pulmonary tumors with ultrasound guided biopsy can provide evidences for the clinics to make therapeutic plans,the method definitely has important clinical values.But the princeps factor of ultrasound guided biopsy is the revealing and identifying of the small central tumor,which should be attached importonce to.

关 键 词：超声检查 肺肿瘤 活组织检查 针吸 诊断 

分 类 号：R730.41[医药卫生—肿瘤]