C臂引导下经皮椎体穿刺活检在胸腰椎转移瘤中的临床诊断价值  

Application of C-Arm Guided Percutaneous Puncture Biopsy in Thoracic and Lumbar Metastatic Tumor and Its Influencing Factors

作　　者：张曙光 赵振国 张鑫鑫 徐立斌 许宋锋 刘婷 王鲁强 李晓阳 于胜吉 ZHANG Shu-guang;ZHAO Zhen-guo;ZHANG Xin-xin;XU Li-bin;XU Song-feng;LIU Ting;WANG Lu-qiang;LI Xiao-yang;YU Sheng-ji(National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院,北京100021

出　　处：《肿瘤学杂志》2021年第11期956-960,共5页Journal of Chinese Oncology

基　　金：首都临床特色应用研究(Z171100001017210);中国癌症基金会北京希望马拉松专项基金联合攻关课题(LC2016L01);中国医学科学院医学与健康科技创新工程项目(2017-I2M-1-005);吴阶平医学基金会临床科研专项资助基金(320.6750.14298)。

摘　　要：[目的]探究C臂引导下经皮椎体穿刺活检在胸腰椎转移瘤中的临床诊断价值及其影响因素。[方法]收集162例行C臂引导下经皮椎体穿刺活检的胸腰椎转移瘤患者的临床病理资料及病变椎体相关因素,采用χ;检验及多因素Logistic回归分析对椎体病理活检准确率的影响。[结果]162例患者的穿刺活检诊断准确率为69.75%(113/162)。术前放疗、手术椎体数目和椎体破坏形式与椎体活检的准确率相关。Logistic多因素回归分析发现,三者均为影响椎体穿刺活检诊断准确率的独立危险因素(P均<0.05)。[结论]C臂引导下椎体穿刺活检病理诊断是明确脊柱转移瘤的有效方式,溶骨性病变部位以及多椎体多点多量取材有助于进一步提高椎体穿刺病理诊断准确率;放疗后患者易出现假阴性,需要综合评估。[Objective]To evaluate the application of C-arm guided percutaneous vertebral puncture biopsy in thoracic and lumbar metastases and its influencing factors.[Methods]The clinical and pathological data of 162 patients with thoracic and lumbar metastases who underwent percutaneous puncture biopsy under C-arm guidance in our hospital were collected,and the factors related to the diagnostic accuracy were analyzed byχ;test and multivariate Logistic regression analysis.[Results]The diagnostic accuracy of percutaneous puncture biopsy in 162 patients was69.75%(113/162).Logistic regression analysis showed that preoperative radiotherapy,number of operated vertebral bodies and types of vertebral destruction were independent risk factors for the accuracy of vertebral puncture biopsy(P<0.05).[Conclusion]The C-arm guided vertebral puncture biopsy is an effective way to identify spinal metastases.The location of osteolytic lesions and multi-point and multi-volume sampling of vertebral bodies are helpful to further improve the accuracy of pathological diagnosis.Radiotherapy patients are prone to false negative and need comprehensive evaluation.

关 键 词：穿刺活检 椎体转移瘤 准确率 影响因素 

分 类 号：R738.1[医药卫生—肿瘤]