| 李帅,王猛,高飞,周志刚.CT引导下经皮肺穿刺活检鉴别肺良、恶性磨玻璃结节[J].中国介入影像与治疗学,2026,23(6):355-359 |
| CT引导下经皮肺穿刺活检鉴别肺良、恶性磨玻璃结节 |
| CT-guided percutaneous transthoracic lung biopsy for differentiating pulmonary benign and malignant ground-glass nodules |
| 投稿时间：2026-03-16 修订日期：2026-05-09 |
| DOI：10.13929/j.issn.1672-8475.2026.06.007 |
| 中文关键词: 肺肿瘤 穿刺术 活组织检查 并发症 体层摄影术，X线计算机 |
| 英文关键词:lung neoplasms punctures biopsy complications tomography,X-ray computed |
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| 中文摘要: |
| 目的 观察CT引导下经皮肺穿刺活检（CT-PTLB）用于鉴别肺良、恶性磨玻璃结节（GGN）的价值。方法 回顾性收集443例接受CT-PTLB的肺GGN患者，共纳入443个结节，包括良性95个、恶性348个；根据直径分为≤10 mm组（A组，n=215）、＞10 mm且≤20 mm组（B组，n=181）及＞20 mm组（C组，n=47）。以术后病理或12个月及以上影像学随访结果为参考标准评估CT-PTLB的鉴别效能；利用logistic回归分析观察CT-PTLB后并发症的独立危险因素。结果 CT-PTLB鉴别肺良、恶性GGN的敏感度为89.08%、特异度为100%、准确率为91.42%，阳性预测值为100%、阴性预测值为71.43%；3组间准确率及敏感度差异有统计学意义且均随结节直径增大而升高（P均＜0.05）。CT-PTLB后54例（54/443，12.19%）发生气胸、111例（111/443，25.06%）发生肺内出血；A组、B组、C组气胸发生率分别为12.56%（27/215）、10.50%（19/181）、17.02%（8/47），肺内出血发生率分别为25.58%（55/215）、24.86%（45/181）、23.40%（11/47），3组间差异均无统计学意义（P均＞0.05）。logistic回归分析结果显示，穿刺经肺深度及穿刺时间为气胸的独立危险因素（P均＜0.05），且前者为肺内出血的独立危险因素（P＜0.05）。结论 CT-PTLB有助于鉴别肺良、恶性GGN。 |
| 英文摘要: |
| Objective To observe the value of CT-guided percutaneous transthoracic lung biopsy （CT-PTLB） for differentiating pulmonary benign and malignant ground-glass nodules （GGN）. Methods A total of 443 pulmonary GGN in 443 patients who underwent CT-PTLB were retrospectively enrolled， including 95 benign and 348 malignant nodules. Then GGN were divided into ≤10 mm group （group A， n=215）， ＞10 mm and ≤20 mm group （group B， n=181）， and ＞20 mm group （group C， n=47）. Taken postoperative pathology or imaging follow-up results for no less than 12 months as the reference standards， the efficacy of CT-PTLB for differentiating benign and malignant GGN was evaluated， and the independent risk factors of complications after CT-PTLB were screened with logistic regression analysis. Results The sensitivity， specificity， accuracy， positive predictive value and negative predictive value of CT-PTLB for differentiating pulmonary benign and malignant GGN was 89.08%， 100%， 91.42%， 100% and 71.43%， respectively. Significant differences of the accuracy and sensitivity were found among 3 groups， and both the accuracy and sensitivity increased with the increase of nodule diameter （both P＜0.05）. After CT-PTLB， 54 cases （54/443， 12.19%） developed pneumothorax and 111 cases （111/443， 25.06%） developed pulmonary hemorrhage. The incidence of pneumothorax in group A， B and C was 12.56% （27/215）， 10.50% （19/181） and 17.02% （8/47）， respectively， and of pulmonary hemorrhage was 25.58% （55/215）， 24.86% （45/181） and 23.40% （11/47）， respectively， both not significantly different among 3 groups （both P＞0.05）. Logistic regression analysis results showed that the puncture depth into lung and puncture time were both independent risk factors of pneumothorax （both P＜0.05）， and the former was independent risk factor of pulmonary hemorrhage （P＜0.05）. Conclusion CT-PTLB was helpful for differentiating pulmonary benign and malignant GGN. |
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