超声引导下穿刺活检胸部病变诊断正确率的影响因素分析  

Analysis of factors influencing the diagnostic accuracy of ultrasound-guided percutaneous biopsy of chest lesions

作　　者：刘连凤[1] 李航[1] 刘军杰[1] 丁战玲[1] 

机构地区：[1]广西医科大学附属肿瘤医院超声科,广西南宁530021

出　　处：《临床肺科杂志》2015年第8期1380-1384,共5页Journal of Clinical Pulmonary Medicine

基　　金：广西壮族自治区高等学校科学研究项目(No KY2015LX064)

摘　　要：目的探讨超声引导下穿刺活检胸部病变诊断正确率的影响因素。方法收集因胸部病变行超声引导下穿刺活检术的178例患者的临床及病理资料,采用单因素和多因素Logistic回归分析方法,分析患者相关因素(性别,年龄)、病灶相关因素(病灶的大小,部位,性质,血供,病灶内有无坏死、病理类型)、操作相关因素(穿刺胸膜次数)对活检诊断正确率的影响。结果 1178例患者中,良性病变23例,恶性病变155例,穿刺活检最终获得明确病理诊断的148例,穿刺诊断正确率为83.15%(148/178);良性病变诊断正确率为60.87%(14/23),恶性病变诊断正确率为86.45%(134/155);2单因素分析结果显示病灶的大小、性质、病灶内有无坏死对穿刺活检的诊断正确率均有影响(P<0.05);多因素分析结果显示病灶的大小(OR=2.235,P=0.019)、性质(OR=3.785,P=0.011)、病灶内有无坏死(OR=0.206,P=0.001)均为穿刺活检诊断正确率的独立影响因素。结论影响超声引导下穿刺活检胸部病变的诊断正确率因素较多,除病人的配合、操作者的熟练程度等潜在因素外,病灶的大小、性质以及病灶中有无坏死是穿刺活检诊断正确率的独立影响因素,其中病灶的性质对其影响最为显著。Objective To investigate the factors influencing the diagnostic accuracy of ultrasound-guided percutaneous biopsy of chest lesions. Methods The clinical and pathological data of 178 patients who had underg-one ultrasound-guided percutaneous biopsy in chest lesions were collected. The single and multivariate stepwise logis-tic retrospective study were made to study the influence of the patient-related factors （sex, age）, lesion-related fac-tors （lesion size, location, blood supply, with or without necrosis, nature of the lesion, pathological types）, and procedure factors （number of pleural passed） on the diagnostic accuracy of ultrasound-guided. Results ① 155 le-sions were diagnosed as malignant and 23 lesions as benign. The diagnostic accuracy rate of ultrasound-guided percu-taneous biopsy was 83. 15 % （148 / 178）. The diagnostic accuracy of ultrasound-guided biopsy for benign and malig-nant lesions were 60. 87% （14 / 23） and 86. 45% （134 / 155）. ② The results in single factor analysis showed that lesion size, nature of the lesion, with or without necrosis had an effect on the accuracy of the biopsy （P 〈 0. 05）. During multi-factor analysis, lesion size （OR = 2. 235, P = 0. 019）, nature of the lesion （OR = 3. 785, P = 0. 011）, lesions with or without necrosis （OR = 0. 206, P = 0. 001） were the independent factors. Conclusion The diagnos-tic accuracy of biopsy is influenced by varied factors. Excluding the human factors, lesion size, nature of the lesion, with or without necrosis are independent factors of the diagnostic accuracy of biopsy, and the nature of the lesion has the greatest impact.

关 键 词：超声检查 胸部病变 活检术 诊断准确率 影响因素 

分 类 号：R445.1[医药卫生—影像医学与核医学]