Clinical Value Of Computed Tomography-guided Percutaneous Transthoracic Needle Biopsy

Objective: To investigate the clinical value of percutaneous transthoracic needle biopsy(PTNB)in the diagnosis of pulmonary lesions.Materials and methods: The clinical records,imaging data and pathological data of patients who underwent PTNB in hospital from April 2013 to September 2019 were collected and retrospectively analyzed.There were 378 males and 167 females,whose average age were(61.10±10.99).1.The CT-guided lung puncture biopsy was performed to calculate the success rate,diagnosis rate,and pathological results.2.Statistics of postoperative complications and their incidence.3.Chi-square test and logistic regression were used to find the related risk factors and independent risk factors of postoperative pneumothorax and pulmonary hemorrhage.Results:1.In this study,the surgical data of 545 patients were collected,and 562 cases of lung biopsy were performed.560 cases of lung biopsy were successfully punctured,puncturesuccess rate 99.64%(560/562).And 480 patients were definitely diagnosed,accuracy rate 88.07%(480/545).2.Among 545 cases recruited,318 were diagnosed as malignant tumors.Pathological classifications were adenocarcinoma(n=160),squamous carcinoma(n=101),small cell lung cancer(n=25),undifferentiated cancer(n=16),adenosquamous carcinoma(n=5),leimyosarcoma(n=1),malignant lymphoma(n=1),Metastatic pulmonary myeloma(n=1),Myoepithelial carcinoma(n=1),solitary fibrous tumor(n=1),clear cell tumors of lung(n=1),thymoma(n=4),Mucinous tumor(n=1).And 162 were diagnosed as Benign lung disease.Pathological classifications were pneumonia(n=56),tuberculosis(n=50),pulmonary abscess(n=13),Inflammatory pseudotumor(n=17),chronic inflammation(n=13),organizing pneumonia(n=5),Interstitial pneumonia(n=2),pulmonary sarcoidosis(n=1),Pulmonary eosinophilia(n=1),Thymic cyst(n=1),Sclerosing hemangioma(n=1),Pulmonary Fungal Infection(n=1),Bronchogenic cyst(n=1).3.After 562 times of lung puncture,pneumothorax occurred111 cases(19.75%),pulmonary hemorrhage 150 cases(26.70%),and pleural reaction 1 case(0.18%).No complications such as infection,hemopneumothorax,tumor implantation metastasis,systemic air embolism,pericardialtamponade,atrial fibrillation and sudden death were observed.4.The risk factors of pneumothorax are age ? 60 years old(P =0.0006),times of puncture ?2(P =0.0003),lesions in the lower lobe(P =0.0005)and pulmonary hemorrhage(P=0.0109),there was statistical significance.The risk factors of hemorrhage are depth of needle insertion?5cm(P=0.0197),puncture ? 2 times(P =0.0344),and pneumothorax(P =0.0197),there was statistical significance.5.The independent risk factors of pneumothorax are age ? 60 years old(P =0.0009),times of puncture ?2(P =0.0001),lesions in the lower lobe(P =0.0009)and pulmonary hemorrhage(P=0.0108),there was statistical significance.Depth of needle insertion ?5cm(P =0.0236),times of puncture ?2(P=0.0167)and pneumothorax(P =0.0041)are independent risk factors for pulmonary hemorrhage,there was statistical significance.Conclusion: 1.PTNB is highly accurate and safe for the diagnosis of pulmonary lesions.2.Lung biopsy is highly diagnostic not only for common lung tumors,but also for rare lung diseases.3.Age ? 60 years old,times of puncture ? 2,lesions in the lower lobe,and pulmonary hemorrhage are both related risk factors for pneumothorax complications and independent risk factors for pneumothorax.4.Depth of needle insertion ?5cm,times of puncture ?2and pneumothorax are related risk factors for pulmonary hemorrhage and independent risk factors for it occurrence.