CT引导经皮肺活检诊断早期周围型肺癌的价值  

The Value of the CT-guided Lung Biopsy through the Skin to Diagnose the Early Peripheral Lung Cancer

作　　者：吴峰[1] 程传虎[2] 罗雯霏[1] 陈芳许[1] 高运金[1] 

机构地区：[1]广东省惠州市人民医院呼吸科,广东惠州516002 [2]广东省惠州市中心人民医院放射科,广东惠州516001

出　　处：《海南医学》2004年第5期7-8,共2页Hainan Medical Journal

基　　金：20 0 1年广东省惠州市科技局课题立项项目 (惠市科字〔2 0 0 1〕7号 )

摘　　要：目的　评估CT引导经皮肺活检对早期周围型肺癌的诊断价值。方法　 46例周围型肺癌的医学记录被回顾 ,2 0例行纤维支气管镜检查并行刷检和 (或 )活检 ,3 8例行CT引导经皮肺活检 (包括 12例纤支镜检查未见异常者 ) ,9例 (包括 3例CT引导经皮肺活检和 6例纤支镜检查 )因诊断不明确行胸廓切开术 ,所有标本送做细胞学、组织学和微生物学检查。结果　CT引导肺活检病理确诊率 92 .1%( 3 5 3 8例 )显著高于纤支镜检查 10 .0 %( 2 2 0例 ) (P <0 .0 1) ,9例手术全部明确诊断肺癌。CT引导肺活检并发症仅 2例发生少量气胸 ,未做特殊处理 ,发生率 5 .3 %( 2 3 8) ,按肺癌TNM临床分期 :CT引导肺活检确诊肺癌有手术指征为 91.4%( 3 2 3 5例 )而纤支镜确诊 2例均为晚期肺癌。结论　CT引导肺活检是一种安全、并发症低、正确率高和小的侵入性方法 。Objective To evaluate the value of the CT-guided lung biopsy through the skin to diagnose the early lung cancer.Methods 46 cases of peripheral lung cancer were reviewed.20 cases took fiberbronchoscope examinations,brush biopsy and/or biopsy.28 cases,including 12 cases of no findings by fiberbronchoscope,took CT-guided lung biopsy through the skin.9 cases,including 3 cases having taken CT-guided lung biopsy and 6 cases having taken fiberbronchoscope examinations,took thoracotomy because of making no definitive diagnoses.All specimens took cytologic,histological and microbiological examinations.Results The pathological definitive diagnosis rate of 92.1% (35/38) by CT-guided lung biopsy is much higher than 10.0 (2/20) by fiberbronchoscope (P<0.01).9 cases operated were all made definitive diagnoses of lung cancer.Only 2 cases of CT-guided lung biopsy had complications.Small pneumothorax set in without any special treatments.Occurrence of complications is 5.3% (2/38).According to the TNM clincal classificaion of lung cancer:91.4% cases made definitive diagnoses of lung cancer by CT-guided lung biopsy had operation indication while 2 cases made definitive diagnoses by fiberbronchoscope were both advanced lung cancer.Conclusions CT-guided lung biopsy is a safe method with low complications,high rate of correction and little invasion.It can make a definitive diagnosis of early lung cancer rapidly.

关 键 词：CT引导 经皮肺活检 诊断 早期周围型肺癌 纤维支气管镜检查 

分 类 号：R734.2[医药卫生—肿瘤] R730.4[医药卫生—临床医学]