Differences In Lung Cancer Specimens Pathological Results With Computed Tomography Guided Percutaneous Lung Biopsy And Surgical Operation

Objective: At present, lung cancer is the most common primary malignancy of the lung, a serious threat to human health. Pathology results is the gold standard for diagnosis of lung cancer, The pathologic result reliable is also the key foundation that a doctor to select treatment plan and prognosis. With the progress of medicine, bronchial lung cancer pathological diagnosis rate has been greatly improved, but the pathological diagnosis of central type of lung cancer and early peripheral lung cancer on the bronchial cavity outside the rate is still low. computed tomography guided percutaneous lung biopsy is accurate and intuitive, by the help of image reconstruction technique, and it has irreplaceable advantages, Especially for the operation of special cardiac site, such as close to the rear, paravertebral pleuraor chest wall. But the pathological specimens is consistent with the lung lesions ? It will be representative of the whole lesions, there is little literature reports. The purpose of this study want to find the differences in lung cancer specimens pathological results with computed tomography guided percutaneous lung biopsy and surgical operationMethods: Select 2003 January to 2013 December, imaging examination showed that pulmonary masses, by bronchoscopy, sputum cytology smear cytology or biopsy histology examination, pulmonary lesions of patients with the diagnosis was not clear. By CT guided percutaneous puncture biopsy of the lung pathology specimens were obtained(smear and / or biopsy), a definite diagnosis of bronchial lung cancer(NSCLC), it is 192 cases, re operation resection of lung lesions obtained the pathological specimens a total of 91 cases, including male: female =99: 93, age 38 ~ 77 years old, average(52.33 + 11.24) years old. All the patients age and body quality accords with the normal distribution. All of the age of the patients with normal distribution, and in line with the study of the set inclusion criteria and exclusion criteria. Will receive percutaneous lung puncture pathology results(smear cytology and biopsy and smear + biopsy) were compared with operative and pathological findings, and then use statistical methods to analyze.Result: After CT guided percutaneous puncture biopsy of the lung pathology specimens were made after operation excision, puncture in patients with a total of 192 cases. Lung puncture biopsy success rate was 100%. The diagnosis of benign lesions in 88 cases; the tumor cells were found, not clearly divided into type 13 cases; the tumor cells were found in 91 patients with lung cancer, bronchial and clear pathological types of cases, are non-small cell lung cancer, including 35 cases of squamous cell carcinoma, 51 cases of adenocarcinoma, 5 cases of adenosquamous carcinoma. Already by percutaneous lung puncture biopsy to confirm the diagnosis and 91 patients with lung cancer confirmed pathological types, and operation income rate in line with pathological results was 86.81%(79 /91 cases), the false positive rate of diagnosis was 0%. The CT guided 60% compliance rate of percutaneous lung biopsy smear cytology pathological diagnosis and operation pathology result(6/10), CT guided percutaneous 81.48% coincidence rate of pathology diagnosis and operation pathology results of percutaneous lung puncture biopsy(22/27), CT guided percutaneous lung puncture biopsy of two methods(smear cytology + biopsy pathology results at the same time) diagnosis of bronchogenic carcinoma with operation pathology results the coincidence rate was 94.44%(51/54). Patients with CT guided percutaneous biopsy of pulmonary pathology results confirmed the diagnosis of bronchial lung cancer of different pathological types, pathological types and operation with the results of different. Pathological lung biopsy results for squamous cell carcinoma patients with operation pathology results, the coincidence rate was 88.57%(31/35). Pathological lung biopsy results for adenocarcinoma of patients with the results of operation and pathology, the coincidence rate was 86.27%(44/51). Pathological lung biopsy results for adenosquamous carcinoma patients with operation pathology results, the coincidence rate was 80%(4/5). In 91 cases after operation in patients with definite pathological diagnosis, except for the diagnosis of 1 cases of pleomorphic carcinoma, small cell lung cancer were. Adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma by CTguided percutaneous puncture biopsy of the lung were detected in 100%, 93.94%, 30.77%. Preoperative biopsy for adenocarcinoma, confirmed by operation and pathology of 2 cases of squamous cell carcinoma patients, preoperative serum tumor markers CYFRA21-1 elevated in 1 cases, 2 patients showed no increased CEA. Operation and pathology 9 cases adenosquamous carcinoma patients, preoperative puncture pathology in 5 cases were adenocarcinoma, 4 cases were squamous cell carcinoma; pathology of adenocarcinoma patients blood tumor markers CEA, CYFRA21-1 also increased in 3 cases, biopsy for patients with squamous cell carcinoma of the blood tumor markers CEA, CYFRA21-1 and the rise of there are 3 cases. The study of all 192 cases of CT guided percutaneous lung biopsy in patients with postoperative complications occurred in 32 cases, common, the incidence rate was 16.7%; of which 8 cases of hemorrhage patients, the incidence rate was 4.2%, have not been hemostatic treatment, symptoms disappeared within 24 hours; pneumothorax in 24 cases, the incidence rate was 12.5%, need wear a chest closed drainage in 3 patients, all patients 72 hours check sternum lung tissue were completely re expansion. CT guided percutaneous lung biopsy in three ways(smear, biopsy, smear + biopsy) obtained the pathological results with the results of operation and pathology results obtained pathological coincidence rate comparison, the χ2 test, no significant difference in P <0.05.Conclusion: 1.CT guided puncture biopsy of the lung complications were few and mild, is a safe means of inspection. 2.CT guided percutaneous pulmonary biopsy with high success rate, the qualitative diagnosis of bronchial lung cancer rate is high, the false positive rate is low. 3.A single type of bronchial lung cancer by CT guided percutaneous lung biopsy method, the detection rate is higher, the result is more reliable, but the composite type of bronchial lung cancer detection rate is relatively low, the result is not satisfactory. 4.Three ways of percutaneous lung puncture biopsy guided by CT(smear, biopsy, smear + biopsy pathology) coincidence rate of results obtained with operation bypathological results, has significant difference. 5. Non small cell lung cancer of different pathological types has no differenced in diagnosis accuracy rate of, by CT guided percutaneous lung biopsy, the accurate rate is high. 6.Non small cell lung cancer of different pathological types(squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma)by 3 ways(smear,biopsy,smear+biopsy) compare the results obtained with the results of operation and pathology, because of the small sample size, no comparison. 7.CT guided percutaneous lung biopsy pathology results and surgical operation pathology results in line with the high rate of. 8. The blood tumor markers for lung cancer is helpful for assistant diagnosis.