ABSTRACT
Objective To assess the influencing factors of pneumothorax incidence after CT-guided percutaneous core needle biopsy. Methods The clinical and imaging data of 597 patients, who underwent CT-guided percutaneous core needle biopsy in Changhai Hospital of Second Military Medical University from Jan. 2013 to Apr. 2015, were retrospectively analyzed. Pearson Chi-square test, continuity-adjusted Chi-square test and Mann-Whitney U test were used to compare the general characteristics, nidus factors and operational factors between the post-operative pneumothorax and non-pneumothorax patients. Parameter estimation and hypothesis test of logistic regression model were used for univariate and multivariate analyses of the above-mentioned parameters. Results The incidence of pneumothorax after CT-guided percutaneous core needle biopsy was 26.97% (161/597). There were significant differences between the post-operative pneumothorax and non-pneumothorax groups in the age, nidus length-diameter, nidus depth, body position, traversing aerated lung, traversing interlobar fissure and traversing subpleural bleb (Z＝1.971, Z＝3.823, Z＝2.169, χ2 ＝29.196, χ2 ＝11.967, χ2 ＝23.353, χ2 ＝ 29.970; P0.05, P0.01). Multivariate analysis showed that the age68 years old (OR＝1.021, 95% CI 1.002-1.040, P＝0.032), traversing aerated lung (OR＝2.251, 95% CI 1.110-4.566, P＝0.025), traversing interlobar fissure (OR＝5.092, 95% CI 2.630-9.861, P0.001) and traversing subpleural bleb (OR＝6.313, 95% CI 2.312-17.243, P0.001) were risk factors of the post-operative pneumothorax, and nidus length-diameter3.1 cm and supine position were the protecting factors (OR＝0.826, 95% CI 0.732-0.933, P＝0.002; OR＝0.318, 95% CI 0.209-0.483, P0.001). Conclusion The age, nidus length-diameter, body position (supine), traversing aerated lung, traversing interlobar fissure and traversing subpleural bleb are the influencing factors of pneumothorax incidence after CT-guided percutaneous core needle biopsy.
ABSTRACT
Objective This study was to investigate the diagnostic value of CT-guided percutaneous needle lung biopsy ( PN-LB) in different types of lung cancer and compare the pathological results of CT-guided PNLB and surgical specimens. Methods We performed a retrospective analysis of 324 cases of lung cancer, all confirmed by CT-guided PNLB after imaging manifestation of lung-occupying lesion and treated by surgical resection.We compared the pathological results of CT-guided PNLB and surgical speci-mens. Results The total coincidence rate of the pathological result from CT-guided PNLB with that from surgical specimens was 85.8% (278/324), with even a higher coincidence rate (96.4%) in adenocarcinoma, followed by squamous cell carcinoma (86.1%), and small cell lung cancer (45.5%).Large cell lung cancer and adenosquamous carcinoma were liable to be diagnosed as adenocarcinoma by CT-guided PNLB ( 7/10 and 6/10 ) .McNemar-Bowker test revealed no significant differences in the coincidence rate in adenocarcinoma, squamous cell carcinoma, and small cell lung cancer (κ=0.837, P=0.215). Conclusion CT-guided PNLB has a high coincidence rate with surgical specimens in the pathological diagnosis of lung cancer, but the coincidence rate varies with different pathological types of the tumor.