| ObjectiveIn recent years,the incidence and mortality of lung cancer have been rising,and China has become the largest country in lung cancer in the world.Because early lung cancer lacks specific clinical symptoms,it is often diagnosed at the middle and late stages of the disease,and the 5-year survival rate is low in the middle and late stages.Therefore,people pay more and more attention to the early detection and early diagnosis of lung cancer.CT-guided lung biopsy is a kind of examination method with small traumaticity,high puncture success rate and high positive rate.It has become an important imaging examination method for early diagnosis of cancer,and has been widely recognized and applied.Some studies have suggested that SPN with a diameter of 10~30mm has a high risk of malignancy,so early diagnosis should be made to determine the treatment plan.However,CT-guided lung biopsy is an invasive examination method,and various complications are inevitable.Previous literature has done a lot of research on common puncture complications(such as: pneumothorax,hemorrhage)and its influencing factors,but there are few reports on hemoptysis.This article mainly studies the diagnostic value of CT-guided lung biopsy for SPN with a diameter ranging from 10 to 30 mm,and analyzes the occurrence of hemoptysis,thereby improving the diagnostic efficiency of puncture and avoiding the occurrence of hemoptysis.Materials and MethodsClinical,imaging and pathological data of 289 patients with isolated pulmonary nodules(SPN)performed CT guided percutaneous lung puncture in the second affiliated hospital of zhengzhou university from January 2013 to March 2018 were collected.There are 154 male and 135 female among them;Patients aged 11-87,with an average age of 58.7 years,the median age of 59 years old.And according to the diameter,SPN were divided into group A(20 mm<diamete<30 mm)and group B(10 mm?diameter ?20 mm).ResultsAll of the 289 patients were successfully punctured.A total of 276 people were diagnosed with a successful diagnosis rate of 100%,and the total positive rate was 95.5%(276/289).A total of 229 cases were malignant,with a malignant ratio of 79.3%(229/289),of which 89 cases were adenocarcinoma(30.8%),76 cases(26.3%)of squamous cell carcinoma,a large proportion;71 cases(32.6%)showed pneumothorax,86 cases(29.8%)had bleeding around the needle,and 35 cases(12.1%)showed hemoptysis.After chi-square test,P >0.05,there was no difference between group A and group B.In the comparison of malignant rate and incidence of pneumothorax,hemorrhage and hemoptysis,P <0.05.The difference is statistically significant.Univariate analysis of hemoptysis,chi-square test results showed: with the comparison of different lesion size,puncture depth and puncture needle model size,the difference was statistically significant(P <0.05),and the above impact factors as dependent variables for multi-factor logistic regression analysis results.The lesion size(P=0.03,OR=0.312)and needle depth(P=0.02,OR=3.622)were independent risk factors for hemoptysis.Conclusions(1)The malignancy rate of SPN in the range of 10~30mm is higher,and the larger the diameter,the higher the malignant rate;the success rate and positive rate of SPN in the range of 10~30mm are higher,and the diameter of the lesion is not directly relationship.Therefore,CT-guided lung biopsy has a high diagnostic value for SPN in the diameter range.(2)Puncture complications are affected by the diameter of the lesion.SPN with smaller diameter is prone to complications;the occurrence of hemoptysis is related to the size of the lesion and the length of the needle.A suitable puncture path can be chosen to reduce the risk of hemoptysis. |
PDF Full Text Request