摘要
目的:探讨CT引导下经皮穿刺肺活检(PTNB)诊断非小细胞肺癌(NSCLC)准确率及其影响因素。方法:选取2020年5月至2022年5月在本院就诊的98例NSCLC患者为研究对象,均行PTNB并以术后病理检查结果为金标准,统计PTNB诊断NSCLC结果,分析PTNB诊断NSCLC准确率的影响因素。结果:PTNB诊断NSCLC准确率为87.76(86/98),其中,诊断腺癌、鳞癌、大细胞癌、腺鳞癌的准确率分别为91.53%(54/59)、93.94(31/33)、0.00%(0/2)、25.00%(1/4)。单因素分析结果显示,诊断准确组和诊断不准确组在性别、年龄、是否合并钙化、穿刺活检组织大小、穿刺次数比较,差异无统计学意义(P>0.05);在病灶位置、病灶长径、病灶与胸壁的距离、是否合并坏死、穿刺深度比较,差异有统计学意义(P<0.05);多因素分析结果显示,病灶位置为下叶、病灶长径<2cm、病灶与胸壁的距离<2cm、合并坏死是影响PTNB诊断NSCLC准确率的独立危险因素。结论:PTNB应用于NSCLC,诊断腺癌和鳞癌的价值较高,诊断大细胞癌和腺鳞癌准确率偏低,影响PTNB诊断NSCLC准确率的独立危险因素有病灶位置为下叶、病灶长径<2cm、病灶与胸壁的距离<2cm、合并坏死,针对性采取措施,有利于提高诊断准确率。
Objective:To explore the diagnostic accuracy of CT-guided percutaneous transthoracic needle biopsy(PTNB)for non-small cell lung cancer(NSCLC)and its influencing factors.Methods:A total of 98 patients with NSCLC treated in the hospital were enrolled as the research subjects between May 2020 and May 2022.All underwent PTNB.Taking the results of postoperative pathological examination as the golden standard,diagnostic results of PTNB for NSCLC were statistically analyzed,and the influencing factors of diagnostic accuracy were analyzed.Results:The diagnostic accuracy of PTNB for NSCLC was 87.76%(86/98),and the accuracy rates of adenocarcinoma,squamous cell carcinoma,large cell carcinoma and adenosquamous carcinoma were 91.53%(54/59),93.94%(31/33),0.00%(0/2)and 25.00%(1/4),re-spectively.The results of univariate analysis showed that there was no significant difference in gender,age,calcification,size of biopsy tissues or biopsy frequency between accuracy group and non-accuracy group(P>0.05),but there were significant differences in lesion sites,lesion size,distance between lesion and chest walls,necrosis and puncture depth(P<0.05).The results of multivariate analysis showed that lesions at infe-rior lobe,lesion<2cm,the distance between lesions and chest walls<2cm and necrosis were independent in-fluencing factors of diagnostic accuracy rate.Conclusion:PTNB has high diagnostic value for adenocarcinoma and squamous cell carcinoma,but has low diagnostic value for large cell carcinoma and adenosquamous carci-noma.The independent influencing factors of diagnostic accuracy rate include lesions at inferior lobe,lesions<2cm,the distance between lesions and chest walls<2cm and necrosis.Targeted measures is beneficial to in-crease diagnostic accuracy rate.
作者
刘阳
岳孟超
LIU Yang;YUE Mengchao(Bazhong Central Hospital,Sichuan Bazhong 636000,China)
出处
《河北医学》
CAS
2023年第10期1654-1659,共6页
Hebei Medicine
基金
四川省医学科研青年创新课题,(编号:Q15010)。
关键词
CT引导下经皮穿刺肺活检
非小细胞肺癌
准确率
影响因素
CT-guided percutaneous transthoracic needle biopsy
Non-small cell lung cancer
Accuracy rate
Influencing factor
