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快速现场评估在直径≤2.0厘米肺结节的计算机断层扫描引导下经皮肺穿刺活检中的应用

Application of rapid on‑site evaluation in computed tomography‑guided percutaneous transthoracic needle biopsy of pulmonary nodules of ≤2.0 cm in diameter.

作者信息

Wang Dongxu, Zhang Qing, Wang Yuguang, Dou Wei, Ding Guoxu, Wen Qiuting, Han Ying, Du Youli, Li Bo

机构信息

Medical Imaging Center, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang 161006, P.R. China.

Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, P.R. China.

出版信息

Exp Ther Med. 2022 Sep 7;24(5):663. doi: 10.3892/etm.2022.11599. eCollection 2022 Nov.

Abstract

Histopathological findings are the gold standard for diagnosing lung nodules, and Invasive diagnostic procedures such as percutaneous transthoracic needle biopsy (PTNB) are often inevitable for a confirmative diagnosis. However, the traditional biopsy method is inefficient for the diagnosis of small pulmonary nodules (diameter ≤2.0 cm). The present study aimed to investigate the application of rapid on-site evaluation (ROSE) in CT-guided PTNB of pulmonary nodules (≤2.0 cm in diameter). Data from patients undergoing PTNB in the Second Affiliated Hospital of Qiqihar Medical College between June 2018 and June 2021 were retrospectively analyzed. A total of 250 patients were included and divided into the ROSE (n=177) and the non-ROSE groups (n=73). The comparison of these two groups indicated significantly higher specimen adequacy [93.22% (165/177) vs. 71.23% (52/73)] and diagnostic accuracy [90.40% (160/177) vs. 68.49% (50/73)], as well as a significantly lower rate of secondary biopsies [5.08% (9/177) vs. 28.77% (21/73)], in the ROSE group. The coincidence rate between the diagnosis with ROSE and the final pathological results was 96.73%, indicating high consistency (κ=0.925). The results indicated that the application of ROSE in PTNB of pulmonary nodules with a diameter of ≤2.0 cm can ensure sufficient material sampling, improve the diagnostic accuracy and reduce the secondary biopsy rate, without increasing complications. ROSE can ensure high consistency with the results obtained from the pathological evaluation.

摘要

组织病理学检查结果是诊断肺结节的金标准,对于确诊往往不可避免地需要进行诸如经皮经胸针吸活检(PTNB)等侵入性诊断程序。然而,传统活检方法对小肺结节(直径≤2.0 cm)的诊断效率较低。本研究旨在探讨快速现场评估(ROSE)在CT引导下对直径≤2.0 cm的肺结节进行PTNB中的应用。回顾性分析了2018年6月至2021年6月在齐齐哈尔医学院附属第二医院接受PTNB的患者数据。共纳入250例患者,分为ROSE组(n = 177)和非ROSE组(n = 73)。两组比较显示,ROSE组标本充足率[93.22%(165/177)对71.23%(52/73)]、诊断准确率[90.40%(160/177)对68.49%(50/73)]显著更高,二次活检率[5.08%(9/177)对28.77%(21/73)]显著更低。ROSE诊断与最终病理结果的符合率为96.73%,一致性较高(κ = 0.925)。结果表明,ROSE应用于直径≤2.0 cm的肺结节PTNB可确保足够的取材,提高诊断准确率,降低二次活检率,且不增加并发症。ROSE可确保与病理评估结果高度一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97e2/9475333/520fb6fd91a6/etm-24-05-11599-g00.jpg

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