Clinical application value of CT guided percutaneous lung biopsy in patients with negative fiberoptic bronchoscopy / 中国医师进修杂志

ABSTRACT

Objective To evaluate the clinical application value of CT guided percutaneous lung biopsy in patients with negative fiberoptic bronchoscopy. Methods The clinical data of 51 patients with central type lung lesions were retrospectively analyzed and all patients had a negative result of fiberoptic bronchoscopy. Then they underwent the CT guided percutaneous lung biopsy. The number of paracentesis, complication and pathology were recorded. The patients were divided into 3 groups according to the tumor size2.5-4.5 cm group, 4.6-6.5 cm group and>6.5 cm or tumor reaching the segmental bronchus group. Results The tumor diameter of 51 patients was 2.5-10.8 cm, average 4.9 cm. The number of paracentesis was 86 times, and 43 cases (84.3%) obtained definite pathological diagnosis small cell carcinoma of lung in 14 cases, lung squamous cell carcinoma in 11 cases, adenocarcinoma in 6 cases, neuroendocrine carcinoma in 1 case, adenosquamous carcinoma in 4 cases, sclerosing hemangioma in 2 cases, tuberculosis in 2 cases, inflammatory pseudotumor in 2 cases, and large cell carcinoma in 1 case. The incidence of complication was 47.1%(24/51), among which the total slight pneumothorax occurred in 10 cases, intraoperative and postoperative hemoptysis, sputum with blood in 6 cases, greater amounts pneumothorax in 5 cases (3 cases underwent the closed drainage of pleural cavity), puncture path errhysis in 2 cases, thoracic cavity hemorrhage and thoracic wall haematoma in 1 case. No patient died. The 2.5-4.5 cm group had 22 cases, 4.6-6.5 cm group had 17 cases and >6.5 cm or tumor reaching the segmental bronchus group had 12 cases, and there was no statistical difference in the rate of definite pathological diagnosis among 3 groups81.8%(18/22), 14/17 and 11/12, P>0.05;and there was statistical difference in the incidence of complication among 3 group63.6% (14/22), 7/17 and 2/12, P<0.05. Conclusions The preferred examination of central type lung lesions patients is fiberoptic bronchoscopy, but because of diversity of disease, the CT guided percutaneous lung biopsy in the patients with negative fiberoptic bronchoscopy is feasible, safe, with high positive rate of biopsy and lower risk.