Tachibana Keisei, Nakazato Yoshimasa, Tsuchida Shigeru, Kazama Toshifumi, Minato Koichi, Yoshida Tsutomu, Fujita Atsushi, Horikoshi Hiroyuki, Tanaka Ryota, Iijima Misa, Goya Tomoyuki
Division of Diagnostic Pathology, Gunma Prefectural Cancer Center, 617-1 Takahayashi-nishi-cho, Ohta, Gunma, Japan; Department of Surgery, Institute of Medical Sciences, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan.
Diagn Cytopathol. 2013 Dec;41(12):1063-8. doi: 10.1002/dc.22940. Epub 2012 Dec 14.
Computed tomography-guided percutaneous transthoracic needle biopsy (CTNB) of the lung is a well-established diagnostic technique for the evaluation of thoracic lesions. At our institution, we have performed real-time CTNB using automated biopsy needles since 1998 and we introduced immediate cytology in 2004. We evaluate immediate cytology in CTNB to increase the diagnostic accuracy and to reduce the number of inadequate specimens. We retrospectively reviewed a consecutive series of 270 patients (group A: 98 patients before introduction, group B: 172 patients after introduction) who underwent CTNB between 2002 and 2009. We compared the diagnostic performance and the complication rates between two groups. There were no significant differences between groups A and B in patient and lesion characteristics. The rates of one time biopsy were significantly different: 56.1% (55/98) in group A and 69.2% (119/172) in group B. The rates of diagnostic accuracy in groups A and B were 79.6% (78/98) and 94.8% (163/172), respectively; the sensitivity were 74.0% (57/77) and 94.1% (127/135); the specificity were 100% (21/21) and 97.3% (36/37); the rates of major complications were 14.3% (14/98) and 2.9% (5/172). Group B had significantly higher diagnostic accuracy, sensitivity, and a lower complication rate in comparison with group A. CTNB with immediate cytology can improve diagnostic performance and decrease the complication rate. These improvements may help make CTNB less of a burden for patients.
计算机断层扫描引导下经皮肺穿刺针吸活检术（CTNB）是评估胸部病变的一项成熟的诊断技术。自1998年以来，我们机构一直使用自动活检针进行实时CTNB，并于2004年引入即时细胞学检查。我们评估CTNB中的即时细胞学检查以提高诊断准确性并减少不合格标本数量。我们回顾性分析了2002年至2009年间接受CTNB的连续270例患者（A组：引入前98例患者，B组：引入后172例患者）。我们比较了两组之间的诊断性能和并发症发生率。A组和B组在患者和病变特征方面无显著差异。一次活检率有显著差异：A组为56.1%（55/98），B组为69.2%（119/172）。A组和B组的诊断准确率分别为79.6%（78/98）和94.8%（163/172）；敏感性分别为74.0%（57/77）和94.1%（127/135）；特异性分别为100%（21/21）和97.3%（36/37）；主要并发症发生率分别为14.3%（14/98）和2.9%（5/172）。与A组相比，B组具有显著更高的诊断准确率、敏感性和更低的并发症发生率。即时细胞学检查的CTNB可提高诊断性能并降低并发症发生率。这些改进可能有助于减轻患者接受CTNB的负担。
