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首页> 外文期刊>Acta Radiologica >Diagnostic accuracy and complication rate of CT-guided fine needle aspiration biopsy of lung lesions: a study based on the experience of the cytopathologist.
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Diagnostic accuracy and complication rate of CT-guided fine needle aspiration biopsy of lung lesions: a study based on the experience of the cytopathologist.

机译：CT引导的肺部病变细针穿刺活检的诊断准确性和并发症发生率：一项基于细胞病理学家经验的研究。

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BACKGROUND: CT-guided transthoracic needle biopsy is a well-established technique for the diagnosis of focal lung lesions. Fine needle aspiration biopsy (FNAB) requires the presence of a cytopathologist on-site to assess the adequacy of samples. For this reason FNAB is less and less used, and core biopsy is the first-line procedure when an experienced cytopathologist is not immediately available. PURPOSE: To evaluate the accuracy and complication rate of CT-guided FNAB of lung lesions according to the experience of the cytopathologist on-site. MATERIAL AND METHODS: A total of 321 consecutive biopsies were considered. Immediate cytological assessment was performed by an experienced cytopathologist for the first 165 procedures (group A) and by two training pathologists for the remaining 156 biopsies (group B). At the time of FNAB the pathologist assigned a semiquantitative score (0-3) to each specimen to assess its diagnostic quality. All variables between the two groups were analyzed by chi-square and Student's t test. A P value <0.05 was considered statistically significant. RESULTS: For all procedures, overall diagnostic accuracy was 80% for cytology alone, with no statistical difference between the two groups for diagnostic accuracy and sample score assigned. In all, 75% of the cytological samples (75% group A, 74% group B) obtained a higher score with a specific diagnosis of histotype. A post biopsy pneumothorax was detected in 27% of biopsies (25% group A, 28% group B). Thirteen patients (4.0%) required chest tube insertion for treatment. For all cases, the pneumothorax rate was significantly affected by the number of samples obtained (P=0.02), but not by the pleural punctures (P=0.15). There was no statistically significant difference between the two groups concerning the number of needle passes and complication rate (P>0.05). CONCLUSION: The efficacy and safety of CT-guided FNAB is not significantly affected by the training level of the cytopathologist on-site. Moreover, the number of specimens obtained for each procedure is a risk factor for pneumothorax.
机译：背景：CT引导的经胸穿刺活检是诊断肺部病灶的成熟技术。细针穿刺活检（FNAB）需要现场有细胞病理学家来评估样品的充分性。因此，越来越多的人使用FNAB，而当经验丰富的细胞病理学家无法立即获得时，核心活检是一线手术。目的：根据现场细胞病理学家的经验，评估CT引导下的肺损伤的FNAB的准确性和并发症发生率。材料与方法：总共考虑了321次连续活检。立即的细胞学评估由经验丰富的细胞病理学家对前165个步骤（A组）进行，并由两名训练病理学家对其余的156个活检组织（B组）进行。在进行FNAB时，病理学家为每个标本分配了半定量评分（0-3）以评估其诊断质量。两组之间的所有变量均通过卡方检验和St​​udent t检验进行了分析。 P值<0.05被认为具有统计学意义。结果：对于所有程序，仅细胞学检查的总体诊断准确性为80％，两组在诊断准确性和分配的样本评分方面无统计学差异。总体而言，有75％的细胞学样本（A组为75％，B组为74％）在对组织型进行了明确诊断后得分更高。 27％的活检组织中检出活检后气胸（A组为25％，B组为28％）。 13名患者（4.0％）需要插入胸管进行治疗。在所有情况下，气胸发生率均受样本数量的显着影响（P = 0.02），但不受胸膜穿刺的影响（P = 0.15）。两组在针刺次数和并发症发生率上无统计学差异（P> 0.05）。结论：CT引导的FNAB的有效性和安全性不受现场细胞病理学家的培训水平的显着影响。此外，每次手术获得的标本数量是气胸的危险因素。

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