目的:本研究旨在评估透视引导下经皮经胸胸膜钳活检(PTPFB)对渗出性胸腔积液的诊断表现和手术特点。
方法:在2014年5月1日至2023年2月28日期间接受PTPFB的渗出性胸腔积液患者被纳入这项回顾性研究。经皮导管引流(PCD)与PTPFB之间的间隔,活检的数量,程序时间,并对手术相关并发症进行评估。敏感性,特异性,使用PCD引流进行胸膜细胞学检查,并计算诊断恶性肿瘤的准确性,PTPFB,并结合PTPFB和胸膜细胞学检查。
结果:71名患者,包括50名男性和21名女性(平均年龄,69.5±15.3年),包括在这项研究中。最终诊断为良性病变48例(67.6%),恶性病变23例(32.4%)。PCD和活检之间的总间隔为2.4±3.7天。在接受延迟PTPFB的组中,PCD和活检之间的间隔为5.2±3.9天。活检的平均数量为4.5±1.3。平均手术时间为4.4±2.1分钟。1例患者报告轻微出血并发症(1.4%)。敏感性,特异性,胸膜细胞学的准确性,PTPFB,PTPFB和胸膜细胞学联合占47.8%(11/23),100%(48/48),和83.1%(59/71),分别为65.2%(15/23),100%(48/48),和88.7%(63/71),分别为78.3%(18/23),100%(48/48),和93.0%(66/71),分别。细胞学联合PTPFB的敏感性和准确性明显高于单独的细胞学检查(P分别为0.008和0.001)。
结论:透视引导下的PTPFB对渗出性胸腔积液患者是一种准确安全的诊断技术,具有可接受的诊断性能,并发症发生率低,合理的程序时间。
OBJECTIVE: This study aimed to evaluate the diagnostic performance and procedural characteristics of fluoroscopy-guided percutaneous transthoracic pleural forceps biopsy (PTPFB) in patients with exudative pleural effusion.
METHODS: Patients with exudative pleural effusion who underwent PTPFB between May 1, 2014, and February 28, 2023, were included in this retrospective study. The interval between percutaneous catheter drainage (PCD) and PTPFB, number of biopsies, procedural time, and procedure-related complications were evaluated. The sensitivity, specificity, and accuracy of diagnosing malignancy were computed for pleural cytology using PCD drainage, PTPFB, and combined PTPFB and pleural cytology.
RESULTS: Seventy-one patients, comprising 50 male and 21 female (mean age, 69.5 ± 15.3 years), were included in this study. The final diagnoses were benign lesions in 48 patients (67.6%) and malignant in 23 patients (32.4%). The overall interval between PCD and biopsy was 2.4 ± 3.7 days. The interval between PCD and biopsy in the group that underwent delayed PTPFB was 5.2 ± 3.9 days. The mean number of biopsies was 4.5 ± 1.3. The mean procedural time was 4.4 ± 2.1 minutes. Minor bleeding complications were reported in one patient (1.4%). The sensitivity, specificity, and accuracy for pleural cytology, PTPFB, and combined PTPFB and pleural cytology were 47.8% (11/23), 100% (48/48), and 83.1% (59/71), respectively; 65.2% (15/23), 100% (48/48), and 88.7% (63/71), respectively; and 78.3% (18/23), 100% (48/48), and 93.0% (66/71), respectively. The sensitivity and accuracy of cytology combined with PTPFB were significantly higher than those of cytological testing alone (P = 0.008 and 0.001, respectively).
CONCLUSIONS: Fluoroscopy-guided PTPFB is an accurate and safe diagnostic technique for patients with exudative pleural effusion, with acceptable diagnostic performance, low complication rates, and reasonable procedural times.