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| 超声引导穿刺活检鉴别病灶良恶性的应用价值 |
| 尹莉,郭瑞君 |
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| (首都医科大学附属北京朝阳医院) |
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| 摘要: |
| 目的 评价超声引导穿刺活检(ultrasound-guided biopsy, USGB)对病灶定性诊断的应用价值。 方法 回顾性分析2012年1月至2016年4月在我院接受USGB肿物性质待查患者343例临床及病理资料,计算穿刺成功率、灵敏度、特异度、误诊率、漏诊率、阳性预测值、阴性预测值、正确率(诊断符合率)、youden指数、阳性似然比、阴性似然比及Kappa值。 结果 343 例患者共343个病灶,325个穿刺标本可获得明确定性诊断,穿刺成功率94.75%(325/343)。经术后病理证实,恶性202个,良性141个,USGB误诊10个,漏诊14个,正确率93.00%(319/343),灵敏度、特异度、误诊率、漏诊率、阳性预测值、阴性预测值、youden指数、阳性似然比及阴性似然比分别为93.07%(188/202),92.91%(131/141),7.09%(12/141),6.93%(14/202),94.95%(188/198),90.34%(131/145),85.98%,13.12,0.07。USGB与金标准诊断总体一致性好,Kappa值0.86(p＞0.05)。 结论 USGB穿刺成功率高,诊断病灶良恶性正确率高,与金标准一致性好,对临床诊断及指导治疗有重要价值。 |
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| DOI： |
| 投稿时间：2017-06-06修订日期：2017-07-02 |
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| Application of ultrasound-guided biopsy in identification of benign or malignant mass |
| Yin Li,Guo Ruijun |
| (Department of Ultrasound,Beijing Chaoyang Hospital,Capital Medical University,Beijing,China,100020) |
| Abstract: |
| Objective To evaluate the value of ultrasound-guided biopsy（USGB） in diagnosing benign or malignant masses. Methods The clinical and pathological dates were collected from 343 patients who had undergone USGB for suspected malignant masses during the period from January 2012 to April 2016 in Beijing Chaoyang Hospital. According to different body parts, they were sort into 7 groups, including 57 cases in lung mass, 30 in liver, 56 in breast, 47 in thyroid, 47 in pleura, 102 in soft tissue and 4 in mediastinum. All the specimens were sent for pathological examination, and add with immunohistochemically technology if necessary. The samples in which tumor cells or diagnostically benign cells could be found were defined as puncture success, whereas the samples including fibrous connective tissue, necrosis or non - specific benign cells, which cannot be clearly identified were picture failure. All the patients were clinically diagnosed by their post-operative pathological diagnosis. To decrease omission diagnostic rate, puncture failure cases were classified into malignant group. The success rate of USGB and epidemiological indicators of total coincident rate(π)，sensitivity, specificity, mistake diagnostic rate, omission diagnostic rate, positive predict value, negative predict value, Youden index(YI), positive likelihood rate, negative likelihood rate, Kappa value were calculated. Results Among 343 cases，202 were diagnosed as malignant and 141 as benign．The success rate of USGB was 94.75%(325/343).10 cases were misdiagnosed，14 cases were failed to be tested malignantly, and πwas 93.00%(319/343). The sensitivity, specificity, mistake diagnostic rate, omission diagnostic rate, positive predict value, negative predict value, YI, positive likelihood rate, negative likelihood rate of ultrasound-guided prostate biopsy were 93.07%（188/202），92.91%（131/141），7.09%（12/141），6.93%（14/202），94.95%（188/198），90.34%（131/145），85.98%（Se+Sp-1），13.12[Se/（1-Sp）]，0.07[ (1-Se)/Sp] respectively, the consistency was great (Kappa=0.86, P＞0.05). Conclusion USGB with high puncture success rate, total coincident rate and great consistency, has significant value in clinical diagnosing and guiding treatment. |
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