Department of Diagnostic Ultrasound, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi, China.
Department of Diagnostic Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China.
Can Respir J. 2023 Jun 9;2023:5815755. doi: 10.1155/2023/5815755. eCollection 2023.
This study aimed to explore the predictive factors of nonmalignant pathological diagnosis and final diagnosis of ultrasound-guided cutting biopsy for peripheral pulmonary diseases. A total of 470 patients with peripheral lung disease diagnosed as nonmalignant by ultrasound-guided cutting biopsy in the First Affiliated Hospital of Guangxi Medical University from January 2017 to May 2020 were included. Ultrasound biopsy was performed to determine the correctness of pathological diagnosis. Independent risk factors of malignant tumor were predicted by multivariate logistic regression analysis. Pathological biopsy results showed that 162 (34.47%) of the 470 biopsy data were specifically benign, and 308 (65.53%; malignant lesions: 25.3%, benign lesions: 74.7%) were nondiagnostic findings. The final diagnoses were benign in 387 cases and malignant in 83 cases. In the nondiagnostic biopsy malignant risk prediction analysis, lesion size (OR = 1.025, = 0.005), partial solid lesions (OR = 2.321, = 0.035), insufficiency (OR = 6.837, < 0.001), and presence of typical cells (OR = 34.421, = 0.001) are the final important independent risk factors for malignant tumors. In addition, 30.1% (25/83) of patients with nonmalignant lesions who were finally diagnosed with malignant tumors underwent repeated biopsy, and 92.0% (23/25) were diagnosed during the second repeated biopsy. 59.0% (49/83) received additional invasive examination. Nondiagnostic biopsy predictors of malignant risk include lesion size, partial solid lesions, insufficiency, and presence of atypical cells. When a nonmalignant result is obtained for the first time, the size of the lesion, whether the lesion is subsolid, and the type of pathology obtained should be reviewed.
本研究旨在探讨超声引导下经皮肺穿刺活检对肺周围疾病非恶性病理诊断及最终诊断的预测因素。回顾性分析 2017 年 1 月至 2020 年 5 月广西医科大学第一附属医院收治的经超声引导下经皮肺穿刺活检诊断为非恶性的 470 例肺周围疾病患者的临床资料。所有患者均进行超声引导下穿刺活检，以确定病理诊断的正确性。采用多因素 Logistic 回归分析预测恶性肿瘤的独立危险因素。病理活检结果显示，470 例活检资料中，162 例（34.47%）为明确良性，308 例（65.53%；恶性病变：25.3%，良性病变：74.7%）为非诊断性发现。最终诊断良性 387 例，恶性 83 例。在非诊断性活检恶性风险预测分析中，病灶大小（OR=1.025， =0.005）、部分实性病灶（OR=2.321， =0.035）、取材不足（OR=6.837， <0.001）、典型细胞存在（OR=34.421， =0.001）是最终发生恶性肿瘤的重要独立危险因素。此外，最终诊断为恶性肿瘤的非恶性病变患者中有 30.1%（25/83）接受了重复活检，其中 92.0%（23/25）在第二次重复活检时得到诊断。92.0%（23/25）在第二次重复活检时得到诊断。59.0%（49/83）接受了额外的有创检查。恶性风险的非诊断性活检预测因素包括病灶大小、部分实性病灶、取材不足和存在非典型细胞。当首次获得非恶性结果时，应重新评估病灶大小、病灶是否为亚实性以及获得的病理类型。
