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目的 通过对外周型原发性肺癌 B超引导下细针抽吸活检及自动活检枪切割活检的两种方法的比较 ,寻求一种最适合临床的活检方法。方法 1993年 8月～ 2 0 0 3年 8月我们先后对 6 6例最终通过外科手术后病理确诊为外周型肺癌患者进行了超声引导下经皮穿刺活检 ,其中细针抽吸活检 33例 ,自动活检枪切割活检 33例 ,对两种检查法阳性检出率、并发症等进行比较分析。结果 自动活检枪切割活检组在总检出率、肿瘤细胞分类及病理学阳性检出率上明显高于细针抽吸活检组 ,前者阳性率分别为 93.93%、90 .32 %、84 .84 % ,后者仅为 75 .75 %、6 4 %、4 5 .4 5 % ,两组率的比较 ,P<0 .0 5 ,而在细胞学检查阳性率及并发症发生率上无明显差别 ,两组细胞学检查阳性率及并发症的发生率分别为 :78.78%、12 .12 %和 6 9.6 9%、9.0 9% ,两组率的比较 ,P>0 .0 5。结论 在有条件的医院 ,应该尽可能地使用自动活检枪切割活检 ,它不但能有效提高肺癌的确诊率 ,减少误诊率 ,因为它具有较高的肿瘤细胞分类能力 ,为药物治疗和外科手术提供极为重要的病理学依据。
Objective To compare the two methods of biopsy of fine needle aspiration biopsy and automatic biopsy gun guided by B-ultrasonography in peripheral type primary lung cancer, and to find a most suitable clinical biopsy method. Methods From August 1993 to August 2003, we performed ultrasound-guided percutaneous biopsy of 66 patients with peripheral-type lung cancer who were finally confirmed by pathology after surgery. Among them, 33 were fine needle aspiration biopsy, Automatic biopsy gun biopsy in 33 cases, positive detection rate of the two tests, comparisons, etc. were analyzed. Results The positive rates of positive detection rate, tumor cell classification and pathology were significantly higher in the biopsy group than in the needle aspiration biopsy group (93.93%, 90.32%, 84.84, respectively) %, The latter was only 75.75%, 64%, 45.54%, the two groups were compared, P <0. 05, and no significant in the cytology positive rate and the incidence of complications The difference between the two groups in the positive rate of cytology and the incidence of complications were: 78.78%, 12.12% and 69.69%, 9.09%, respectively. There was no significant difference between the two groups (P> 0.05). CONCLUSION: In conditional hospitals, biopsy should be performed using automatic biopsy gun whenever possible. It not only can effectively improve the diagnosis of lung cancer but also reduce the misdiagnosis rate because of its high ability of tumor cell classification for drug treatment and surgery The most important pathological basis.