快速现场细胞学评估在肺穿刺活检中的应用  

The application of rapid on-site cytological evaluation for percutaneous lung biopsy

作　　者：王承志[1] 王咏梅[1] 杨庆婵 WANG Cheng-zhi;WANG Yong-mei;YANG Qing-chan(Department of Pathology,Tianjin Haihe Hospital,Tianjin Institute for Respiratory Diseases,Tianjin 300350,China)

机构地区：[1]天津市海河医院病理科,天津市呼吸疾病研究所,300350

出　　处：《天津医药》2021年第1期94-97,共4页Tianjin Medical Journal

摘　　要：目的探讨快速现场细胞学评估(C-ROSE)在肺穿刺活检中的应用价值。方法对291例肺内病变的患者行经皮肺穿刺活检,根据术中是否采用C-ROSE分为C-ROSE组148例和非C-ROSE组143例,对比2组间临床资料、穿刺情况及并发症等,同时分析C-ROSE细胞学诊断的敏感度和与最终组织学诊断的一致性。结果C-ROSE组148例中有137例(92.6%)获得满意标本,最终病理学确诊率93.9%;非C-ROSE组143例中有120例(83.9%)获得满意标本,最终病理学确诊率86.0%。C-ROSE组标本满意程度和最终病理学确诊率均优于非C-ROSE组(均P<0.05)。C-ROSE组对照最终病理组织学诊断,敏感度为88.0%(81/92),特异度为96.4%(54/56),两者诊断上有较好的一致性(Kappa值为0.819)。C-ROSE组活检时间(15.32±2.81)min,平均穿刺数(1.41±0.55)针,较非C-ROSE组活检时间(14.08±2.33)min,平均穿刺数(1.20±0.40)针有所增多(均P<0.01)。C-ROSE组出现气胸18例(12.2%),肺部出血14例(9.5%);非C-ROSE组出现气胸22例(15.4%),肺部出血14例(9.8%),2组患者间并发症差异均无统计学意义(均P>0.05)。结论C-ROSE在经皮肺穿刺活检可指导手术医生取材,提高活检成功率和诊断率,同时CROSE在细胞学诊断中也有较高的敏感度和与组织学诊断的一致性,值得临床上推广。Objective To explore the applicative value of rapid on-site cytological evaluation(C-ROSE)for percutaneous lung biopsy.Methods A total of 291 patients with intrapulmonary diseases underwent percutaneous lung biopsy were included in this study.Patients were divided into C-ROSE group(n=148)and non-C-ROSE group(n=143)according to whether C-ROSE was used during the operation.Clinical data,puncture conditions and complications were compared between the two groups.The sensitivity of C-ROSE cytological diagnosis and the consistency with the final histological diagnosis were analyzed.Results In 148 patients of C-ROSE group,137 cases(92.6%)were received satisfactory specimens,and the final pathological diagnosis rate was 93.9%.Of the 143 non-C-ROSE patients,120(83.9%)obtained satisfactory specimens,and the final pathological diagnosis rate was 86.0%.The sample satisfaction and final pathological diagnosis rate were better in the C-ROSE group than those of the non-C-ROSE group(all P<0.05).The sensitivity and specificity of C-ROSE control for final histopathological diagnosis were 88.0%(81/92)and 96.4%(54/56),with good consistency in diagnosis(Kappa value was 0.819).In the C-ROSE group,the biopsy time was(15.32±2.81)min,and the average number of puncture needles was(1.41±0.55)times.The biopsy time was(14.08±2.33)min in the non-CROSE group and the average number of puncture needles was(1.20±0.40)times.The biopsy time and the number of puncture needles were higher in the C-ROSE group than those in the non-C-ROSE group(all P<0.01).In the C-ROSE group,pneumothorax occurred in 18 patients(12.2%)and pulmonary hemorrhage in 14 patients(9.5%).In the non-CROSE group,pneumothorax occurred in 22 patients(15.4%)and pulmonary hemorrhage in 14 patients(9.8%).There were no statistically significant differences in the complications of pneumothorax and pulmonary hemorrhage between the two groups(all P>0.05).Conclusion C-ROSE percutaneous lung biopsy can guide surgeons to take materials,improve the success rate and diagnosis rate of biop

关 键 词：胸腔穿刺术 细胞学技术 现场快速评估 肺部病变 

分 类 号：R446.81[医药卫生—诊断学]