快速现场细胞学评价在CT引导下经皮肺穿刺活检中的应用研究  

Application research of cell rapid on-site evaluation in CT-guided percutaneous lung biopsy

作　　者：黄玉胜 夏蕾 唐翠萍 易守会 杨镇洲 HUANG Yusheng;XIA Lei;TANG Cuiping;YI Shouhui;YANG Zhenzhou(Cancer Center,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院肿瘤中心,400010

出　　处：《重庆医学》2020年第17期2885-2888,共4页Chongqing medicine

基　　金：重庆市科卫联合医学科研项目(2019MSXM024)。

摘　　要：目的探讨CT引导下经皮肺穿刺活检结合快速现场细胞学评价(C-ROSE)在肺周围型肿物诊治中的临床价值。方法选取2018年8月至2019年11月该院肿瘤中心收治的107例胸部CT检查提示周围型肺肿物的患者,随机分为试验组(n=53)和对照组(n=54),行CT引导下经皮肺肿物穿刺活检。试验组将穿刺组织行抹片后再行C-ROSE,对照组穿刺组织不做任何处理。术后对两组组织均行常规组织学病理检测,必要时辅以免疫组织化学协助诊断。结果试验组中C-ROSE灵敏度为97.96%、特异度为100%,与组织学诊断高度一致。试验组与对照组穿刺时间分别为(18.79±3.39)min,(18.09±3.49)min;穿刺次数分别为(3.15±0.89)次,(2.87±0.75)次;穿刺气胸发生率分别为7.55%、5.56%,出血发生率分别为1.89%、1.85%。试验组中无因诊断及基因检测需要二次取材患者。对照组中因诊断需重新取材1例,因基因检测需重新取材3例。结论C-ROSE指导CT引导下经皮肺穿刺活检具有较高临床应用价值。Objective To investigate the clinical value of CT-guided percutaneous lung biopsy combined with rapid on-site cytology evaluation(C-ROSE)in the diagnosis and treatment of peripulmonary tumors.Methods A total of 107 patients who diagnosed with peripulmonary tumors by chest CT examination in this hospital from August 2018 to November 2019,were randomly divided into the experimental group(n=53)and the control group(n=54).CT-guided percutaneous lung biopsy was performed.After biopsy,the experimental group received rapid on-site evaluation,while in the control group,the puncture tissue was not treated.Next,both groups of tissues underwent routine histological and pathological examinations after surgery,supplemented with immunohistochemistry to assist diagnosis if necessary.Results The sensitivity and specificity of C-ROSE in the experimental group were 97.96%and 100%,which were highly consistent with the histological diagnosis.The puncture time of the experimental group and the control group were(18.79±3.39)min and(18.09±3.49)min,respectively.The puncture times were 3.15±0.89 and 2.87±0.75,respectively.The incidence of pneumothorax were 7.55%,5.56%,and the incidence of bleeding were 1.89%and 1.85%respectively.In the control group,1 person needed to be re-resourced for diagnosis,and 3 people needed to be re-resourced for gene testing,while no person needed in the experimental group.Conclusion CT-guided percutaneous lung biopsy combined with C-ROSE has application clinical value.

关 键 词：CT引导 活组织检查 针吸 快速现场评估 周围型肺肿物 

分 类 号：R730.4[医药卫生—肿瘤]