Taïeb S, Bonodeau F, Joveniaux A, Lefèbvre J L, Cabaret V, Besson P
Centre Oscar Lambret, Lille, France.
J Radiol. 1999 Jan;80(1):25-9.
To evaluate the diagnostic accuracy of transthoracic needle biopsy (TNB) in patients being treated for cancer in order to compare results from small and large pulmonary nodules and to study the efficiency of pathology versus cytology analysis.
141 consecutive CT-guided TNBs were performed in 134 patients. Cancer had been diagnosed in all cases. From the CT images, nodules were classified as small (< or = 15 mm) (n = 63; 47%) or large (> 15 mm) (n = 71; 53%).
There were 16 benign and 118 malignant lesions (92 metastasis, 18 primary, 8 unspecified). There was no statistically significant difference for sensitivity and for prevalence of pneumothorax between small or large nodules. For the 107 true-positive and 16 true-negative results, the cytology examination was positive alone in 41 cases (33.3%), the pathology examination in 24 cases (19.5%) and both in 58 cases (47.2%).
The diagnostic efficiency of CT-guided transthoracic needle biopsy is as good for small pulmonary nodules (> or = 15 mm) as for larger lesions. This technique is particularly useful in the diagnosis of secondary lesions and does not increase the risk of complications, even in case of small nodules. Ordering both pathology and cytology examinations improves the efficacy of TNB.
评估经胸针吸活检（TNB）在癌症治疗患者中的诊断准确性，以比较小和大的肺结节的结果，并研究病理与细胞学分析的效率。
对134例患者进行了141次连续的CT引导下TNB。所有病例均已诊断为癌症。根据CT图像，结节被分类为小（≤15mm）（n = 63；47%）或大（>15mm）（n = 71；53%）。
有16个良性病变和118个恶性病变（92个转移瘤、18个原发性肿瘤、8个未明确类型）。小或大结节之间在敏感性和气胸发生率方面无统计学显著差异。对于107个真阳性和16个真阴性结果，细胞学检查单独阳性41例（33.3%），病理检查阳性24例（19.5%），两者均阳性58例（47.2%）。
CT引导下经胸针吸活检对小肺结节（≥15mm）和大病变的诊断效率相同。该技术在继发性病变的诊断中特别有用，即使在小结节情况下也不会增加并发症风险。同时进行病理和细胞学检查可提高TNB的效能。
