Hui Hui, Yin Hai-Tao, Wang Tao, Chen Gang
Department of Radiation Oncology, Xuzhou Central Hospital, Xuzhou, China.
Department of Radiology, Xuzhou Central Hospital, Xuzhou, China.
Kardiochir Torakochirurgia Pol. 2022 Jun;19(2):65-69. doi: 10.5114/kitp.2022.117492. Epub 2022 Jun 29.
Based on the computed tomography (CT) pulmonary nodules (PNs) screening trial, sub-centimeter PNs (SCPNs) with a diameter ≤ 10 mm are observed in approximately 15% of the screened population, of which 48-56% of the cases occur in patients with lung cancer.
To assess the safety and diagnostic precision of CT-guided core needle biopsy (CNB) for SCPNs.
Between January 2016 and December 2018, consecutive patients with PNs underwent a CT-guided CNB procedure. These patients were divided into 2 groups. Group A included patients with SCPNs and group B included patients with PNs of 11-20 mm in diameter. The baseline data, diagnostic performance, and complication rates were compared.
The technical success rates of CT-guided CNB in groups A and B were both 100%. No statistically significant differences were observed in diagnostic yield (43.8% vs. 54.7%, = 0.105), overall accuracy (89.5% vs. 94.0%, = 0.221), and sensitivity (78.8% vs. 90.1%, = 0.080) between the 2 groups. The independent risk factor related to diagnostic failure of SCPNs was CNB-related pneumothorax ( = 0.001). There were no significant differences in the rates of pneumothorax (13.3% vs. 15.4%, = 0.664) and pulmonary hemorrhage (10.5% vs. 8.5%, = 0.624) between the 2 groups. The risk factors related to pneumothorax were decubitus position ( = 0.009) and more needle pathways ( = 0.004). A risk factor associated with pulmonary hemorrhage was greater lesion-pleura distance ( = 0.048).
CT-guided CNB is a safe, reliable, and precise method for the diagnosis of SCPNs.
基于计算机断层扫描（CT）肺结节（PN）筛查试验，在大约15%的筛查人群中观察到直径≤10mm的亚厘米肺结节（SCPN），其中48 - 56%的病例发生在肺癌患者中。
评估CT引导下粗针穿刺活检（CNB）对SCPN的安全性和诊断准确性。
2016年1月至2018年12月，连续的PN患者接受了CT引导下的CNB操作。这些患者被分为两组。A组包括SCPN患者，B组包括直径为11 - 20mm的PN患者。比较两组的基线数据、诊断性能和并发症发生率。
CT引导下CNB在A组和B组的技术成功率均为100%。两组在诊断率（43.8%对54.7%，P = 0.105）、总体准确率（89.5%对94.0%，P = 0.221）和敏感性（78.8%对90.1%，P = 0.080）方面未观察到统计学显著差异。与SCPN诊断失败相关的独立危险因素是CNB相关气胸（P = 0.001）。两组在气胸发生率（13.3%对15.4%，P = 0.664）和肺出血发生率（10.5%对8.5%，P = 0.624）方面无显著差异。与气胸相关的危险因素是卧位（P = 0.009）和更多的穿刺路径（P = 0.004）。与肺出血相关的危险因素是病变与胸膜的距离更大（P = 0.048）。
CT引导下CNB是诊断SCPN的一种安全、可靠且准确的方法。
