摘要
目的探讨CT引导下肺穿刺活检术结合术中快速病理诊断后灌注治疗的临床应用及疗效。方法选取哈尔滨市胸科医院2019年3月~2020年7月160例采取CT引导下肺穿刺活检术的患者,随机分为肺穿刺活检后行常规病理检查组及穿刺活检术结合术中快速病理检查组,每组80例,两组均与术后最终大病理(包括活检病理、外科手术病理、后续临床证实)对比,分析各自的检出率与准确率。并对术中明确诊断的13例非小细胞肺癌行缓释顺铂灌注治疗。结果术中快速病理阳性检出率为92.5%(74/80),明显高于常规病理方法77.5%(62/80)(χ^(2)=7.059,P=0.008)。术中快速病理诊断准确率为80.0%(64/80),明显高于常规病理方法60.0%(48/80)(χ^(2)=7.619,P=0.006);瘤内植入缓释顺铂治疗非小细胞肺癌患者13例,病灶明显缩小3例,稳定8例,进展2例。结论CT引导下肺穿刺活检术结合术中快速病理诊断可显著提高阳性检出率和准确率;瘤内植入缓释顺铂治疗非小细胞肺癌有较好的耐受性、安全性和疗效。
Objective To investigate the clinical applications and effect of CT-guided lung biopsy combined with intraoperative rapid pathological diagnosis and perfusion therapy.Methods A total of 160 patients who underwent CT-guided lung biopsy in Harbin Chest Hospital from March 2019 to July 2020 were selected and randomly divided into two groups:routine pathological examination group after lung biopsy and rapid intraoperative pathological diagnosis group combined with lung biopsy,80 cases in each group.The two groups were compared with the final postoperative pathology(including biopsy pathology,surgical pathology and subsequent clinical confirmation)to analyze their respective detection and accuracy rates.Thirteen cases of non-small cell lung cancer(NSCLC)were treated with sustained release cisplatin infusion.Results The positive rate of rapid pathologic examination was 92.5%(74/80),significantly higher than that of conventional pathologic examination(77.5%(62/80))(χ^(2)=7.059,P=0.008).The accuracy of rapid pathological diagnosis was 80.0%(64/80),significantly higher than that of conventional pathological method(60.0%(48/80))(χ^(2)=7.619,P=0.006).Thirteen cases of NSCLC were treated by intratumoral implantation of sustained-release cisplatin.The lesions were significantly reduced in 3 cases,stable in 8 cases,and progressive in 2 cases.Conclusion CT-guided lung biopsy combined with intraoperative rapid pathological diagnosis can significantly improve the positive detection rate and accuracy rate,and intratumoral implantation of sustained-release cisplatin in the treatment of NSCLC has good tolerance,safety and efficacy.
作者
苏保民
申奥
谢晓霞
陈文军
宫飞飞
张立彬
SU Bao-min;SHEN Ao;XIE Xiao-xia;CHEN Wen-jun;GONG Fei-fei;ZHANG Li-bin(Department of CT Room,Harbin Chest Hospital,Harbin 150056,China;Department of CT Room,Heilongjiang Armed Police Corps Hospital,Harbin 150000,China)
出处
《哈尔滨医科大学学报》
CAS
2021年第6期661-665,共5页
Journal of Harbin Medical University
基金
黑龙江省卫生计生委科研课题(2018408)。
关键词
CT引导下
肺穿刺活检
术中快速病理
缓释顺铂
非小细胞肺癌
CT-guided
lung biopsy
intraoperative rapid pathology
sustained release cisplatin
non-small cell lung cancer
