彩色多普勒超声引导下经皮肺穿刺活检术联合多种方法在老年疑似Ⅰ～ⅢA期肺癌的诊断价值

摘要

Objective To evaluate the values of color Doppler ultrasound ( CDU ) - guided percutaneous lung biopsy surgery combined with a variety of methods in diagnosing suspected Ⅰ ~ Ⅲ A lung cancer in aged population. Methods A total of 151 suspected cases of aged I ~ MA lung cancer patients underwent examinations carried out using TBLB, CT or CDU - guided needle biopsy and a variety of other methods. If one method failed to confirm the diagnosis, another would be used, with the results finally compared with pathological results. Results Diagnosis rates were 71. 6% for CDU - guided percutaneous lung biopsy, 48. 3% for TBLB - guided percutaneous lung biopsy, 67. 4% for CT - guided percutaneous lung biopsy, and 88. 1% for the three methods combined. Diagnosis rate of the combination of the three ways of biopsy was significantly higher than any one single biopsy method used alone ( P < 0. 05 ) . Diagnosis rates were significantly different between CDU - guided percutaneous needle biopsy and TBLB lung biopsy ( P < 0. 05 ), and were similar between CT and CDU - guided percutaneous lung biopsy ( P > 0. 05 ). Conclusion CDU - guided percutaneous lung biopsy combined with a variety of methods can significantly improve the confirming diagnosis of suspected Ⅰ ~ Ⅲ A lung cancer as well as improve the classification of early diagnosis. This approach is worth popularization.%目的 评价彩色多普勒超声(CDU)引导下经皮肺穿刺活检术联合多种方法在老年疑似Ⅰ～ⅢA期肺癌的诊断价值.方法 对疑似Ⅰ～ⅢA期151例肺癌老年患者分别采用经纤维支气管镜肺活检(TBLB)、CT或CDU引导下经皮肺穿刺活检等检查手段行多种方法进行诊断,一种方法未能确诊时再换另一种方法,所得结果与病理结果进行对照.结果 CDU引导下经皮肺穿刺活检术诊断率为71.6%,TBLB诊断率为48.3%,CT引导下经皮肺穿刺活检术诊断率为67.4%,联合各种方法总诊断率为88.1%.联合3种活检方法诊断率与单一活检方法诊断率比较,差异有统计学意义(P＜0.05),其中CDU引导经皮肺穿刺活检术与TBLB穿刺活检术的诊断率比较,差异有统计学意义(P＜0.05);而CT与CDU引导下经皮肺穿刺活检术的诊断率比较,差异无统计学意义(P＞0.05).结论 联合CDU引导下经皮肺穿刺活检术及多种方法可明显提高对疑似Ⅰ～ⅢA期肺癌的诊断率,有利于对早期分类诊断,值得临床推广应用.