两种方法获得的非小细胞肺癌标本病理结果的差异.docVIP

646 Tianjin Med J,June2015,Vol.43No.6两种方法获得的非小细胞肺癌标本病理结果的差异 李波1,王菁2,李月川2△ 摘要:目的探讨CT引导下经皮肺穿刺活检标本病理结果的可靠性,及其对非小细胞肺癌的诊断价值。方法选择非小细胞肺癌患者91例,影像学检查发现肺部肿物,经痰液细胞学、支气管镜的涂片细胞学或活检组织学等检查,均未能明确诊断的肺部病变患者,后经CT引导下经皮肺内病灶穿刺术,获得涂片细胞学和(或活检组织学证据,明确诊断为非小细胞肺癌,再行外科手术切除获得完整的病理结果。比较CT引导下经皮肺穿刺活检不同病理类型及不同途径的病理结果与外科手术切除标本的病理结果的差异。结果CT引导下经皮肺穿刺活检的病理结果与手术结果的符合率为86.81%(79/91。与手术病理结果比较,经皮肺穿刺活检不同病理类型的符合率差异无统计学意义[鳞癌vs腺癌vs腺鳞癌:88.57%(31/35vs86.27%(44/51vs80.00%(4/5,χ2=0.310,P0.05];经皮肺穿刺标本采用不同方法的病理类型结果与手术结果的比较差异有统计学意义(χ2=9.698,P0.05,经涂片细胞学+活检组织学获得病理结果的符合率[94.4%(51/54]高于单独涂片细胞学[60.0%(6/10]和单独活检组织学[81.4%(22/27]。结论CT引导下经皮肺穿刺活检对非小细胞肺癌的定性诊断是可靠的,但其病理类型结果可能与手术结果不一致。 关键词:癌,非小细胞肺;穿刺术;活组织检查,针吸;外科手术;标本;经皮肺穿刺活检;病理 中图分类号:R563.9,R446.8文献标志码:A DOI:10.11958/j.issn.0253-9896.2015.06.018 Value of CT-guided percutaneous lung biopsy in diagnosing non-small cell lung cancer compared with biopsy from surgical approach LI Bo1,WANG Jing2,LI Yuechuan2△ 1Graduate School of Tianjin Medical University,Tianjin300070,China;2Tianjin Chest Hospital △Corresponding Author E-mail:liyuechuandoctor@126.com Abstract:Objective To investigate the reliability of CT-guided percutaneous lung biopsy pathological results in diag?nosing Non-small cell lung cancer(NSCLC.Methods Patients(n=91were selected whose radiology examination re?vealed pulmonary masses but were failed to be confirmed with pulmonary lesion through sputum or bronchoscopy.Then,they were diagnosed as non-small cell lung cancer by CT-guided percutaneous lung biopsy.After that,they received surgical op?eration and biopsies were taken during operations for pathological analysis.Pathological results between from percutaneous lung biopsy(pathological types and using different analysis toolsand from surgical operation were compared.Results The coincidence rate of pathological type is86.81%(79/91using pathological results through percutaneous lung biopsy or oper?ation.Compared with the pathological results of operation,the coincidence rate of pathological type using percutaneous lung biops