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CT 引导下经皮细针抽吸术快速现场评估在肺部占位性病变诊断中的诊断价值。

Diagnostic Value of Rapid On-Site Evaluation for CT-Guided Percutaneous Fine Needle Aspiration in the Diagnosis of Pulmonary Occupying Lesions.

机构信息

The First Clinical Medical College, Hubei University of Medicine, Shiyan, Hubei 442000, China.

Department of Respiratory and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, China.

出版信息

Biomed Res Int. 2020 Nov 17;2020:9842768. doi: 10.1155/2020/9842768. eCollection 2020.

Abstract

OBJECTIVE

Rapid on-site evaluation (ROSE) is an effective and efficient auxiliary examination, but its value for CT-guided percutaneous fine-needle aspiration (FNA) in the diagnosis of pulmonary occupying lesions is unclear. This study is aimed at evaluating the clinical utility of ROSE for CT-guided percutaneous FNA.

METHODS

We reviewed 234 patients from September 2018 to April 2019. The result using ROSE was compared with the final pathological diagnosis of CT-guided percutaneous FNA, and we also compared the complications between the ROSE group and the NO-ROSE group. The final pathological diagnosis results served as the gold standard. We also analyzed the diagnostic rate of FNA and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of malignancy. The correlation between diverse pathological types of lung cancer was also taken into consideration.

RESULTS

In total, 132 patients underwent CT-guided percutaneous FNA with ROSE (ROSE group), and 102 did not (NO-ROSE group). The diagnostic rate, sensitivity, specificity, PPV, and NPV of the ROSE group were 91.6%, 89.1%, 94.1%, 93.4%, and 90.1%, respectively. The complication rates of the ROSE group and the NO-ROSE group were 8.33% and 16.67%, respectively. This difference was not statistically significant ( > 0.05). In subsets of adenocarcinoma (AC) and small cell lung cancer (SCLC) patients, the ROSE result was highly consistent with the final pathological result.

CONCLUSION

CT-guided percutaneous FNA combined with ROSE has a high diagnostic rate, sensitivity, and specificity for pulmonary occupying lesions and an acceptable rate of complications. This method is worthy of wide use given its high efficiency and safety.

摘要

目的

快速现场评估(ROSE)是一种有效且高效的辅助检查,但它在 CT 引导下经皮细针抽吸(FNA)诊断肺部占位性病变中的价值尚不清楚。本研究旨在评估 ROSE 对 CT 引导下经皮 FNA 的临床应用价值。

方法

我们回顾了 2018 年 9 月至 2019 年 4 月的 234 名患者。ROSE 结果与 CT 引导下经皮 FNA 的最终病理诊断进行比较,并比较 ROSE 组和非 ROSE 组的并发症。最终的病理诊断结果作为金标准。我们还分析了 FNA 的诊断率以及恶性肿瘤的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)。还考虑了不同类型肺癌之间的相关性。

结果

共 132 例患者接受 CT 引导下经皮 FNA 联合 ROSE(ROSE 组),102 例患者未接受 ROSE(非 ROSE 组)。ROSE 组的诊断率、敏感性、特异性、PPV 和 NPV 分别为 91.6%、89.1%、94.1%、93.4%和 90.1%。ROSE 组和非 ROSE 组的并发症发生率分别为 8.33%和 16.67%,差异无统计学意义(>0.05)。在腺癌(AC)和小细胞肺癌(SCLC)患者亚组中,ROSE 结果与最终病理结果高度一致。

结论

CT 引导下经皮 FNA 联合 ROSE 对肺部占位性病变具有较高的诊断率、敏感性和特异性,且并发症发生率可接受。该方法具有高效、安全的特点,值得广泛应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ba8/7685792/11a35159bdad/BMRI2020-9842768.001.jpg

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