Efficacy of CT guided percutaneous lung biopsy in patients with lung tumor

doi:10.3877/cma.j.issn.1674-6902.2025.05.016

Abstract

Abstract:

Objective

To analyze the efficacy of computed tomography(CT) guided percutaneous lung biopsy for pulmonary tumors.

Methods

A total of 152 patients with pulmonary tumors who underwent CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) at our hospital from January 2022 to June 2024 were selected as subjects. Using surgical histopathological results as the reference standard, the puncture success rate, diagnostic efficacy, complications, and influencing factors were analyzed.

Results

Among the 152 cases, surgical histopathological results were positive in 103 cases (67.76%) and negative in 49 cases (32.24%). One-time puncture success was achieved in 148 cases (97.37%), while puncture failure occurred in 4 cases (2.63%). Complications occurred in 51 cases, including simple pneumothorax in 27 cases (52.94%). The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT-PTNB for diagnosing pulmonary tumors were 96.71%, 97.09%, 95.92%, 98.04%, and 94.00%, respectively, showing good consistency with surgical histopathological results (Kappa=0.757, P<0.05). The lesion diameter in patients with complications was (3.28±1.01) cm, which was smaller than that in patients without complications (4.33±1.12) cm, while the distance from the lesion to the chest wall was (4.32±1.07) cm, which was greater than that in patients without complications (3.72±0.97) cm (P<0.05). Logistic regression analysis showed that an increase in lesion diameter (OR=0.542, 95%CI: 0.419~0.665) was a protective factor against complications in CT-PTNB, while an increase in the distance from the lesion to the chest wall (OR=3.284, 95%CI: 1.587~4.981) was a risk factor for complications in CT-PTNB (P<0.05).

Conclusion

CT-PTNB demonstrates high accuracy, sensitivity, and specificity in the diagnosis of pulmonary tumors, with a one-time puncture success rate of 97.37%. The complication rate is slightly high, with simple pneumothorax being the main complication. Timely optimization and improvement of preventive measures can help enhance the safety of CT-PTNB.

Key words: Lung tumors, Computed tomography, Puncture biopsy, Complication

Mengjun Xu, Zexian Wang, Yaru Guo, Haibei Dong, Huanhuan Liu, Lingyun Shi, Wen Guo, Feng Liu, Xiaojin Wu, Aihong Cao. Efficacy of CT guided percutaneous lung biopsy in patients with lung tumor[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(05): 752-756.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhfbjbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6902.2025.05.016

https://zhfbjbzz.cma-cmc.com.cn/EN/Y2025/V18/I05/752

Figures/Tables 2

References 28

1	Takamori S, Ishikawa S, Suzuki J, et al. Differential diagnosis of lung cancer and benign lung lesion using salivary metabolites: A preliminary study[J]. Thorac Cancer, 2022, 13(3): 460-465.
2	Zheng S, Shu J, Xue J, et al. CT signs and differential diagnosis of peripheral lung cancer and inflammatory pseudotumor: A Meta-analysis[J]. J Healthc Eng, 2022, 3(9): 3547070.
3	Kajiwara N, Kakihana M, Maeda J, et al. Salivary metabolomic biomarkers for non-invasive lung cancer detection[J]. Cancer Sci, 2024, 115(5): 1695-1705.
4	Nakane K, Yagi K, Yajima S, et al. Salivary metabolomic biomarkers for esophageal and gastric cancers by liquid chromatography-mass spectrometry[J]. Cancer Sci, 2024, 115(9): 3089-3098.
5	国家卫生健康委办公厅. 原发性肺癌诊疗指南(2022年版)[J]. 协和医学杂志，2022, 13(4): 549-570.
6	Pinsky PF, Gierada DS, Black W, et al. Performance of lung-RADS in the national lung screening trial: a retrospective assessment[J]. Ann Intern Med, 2015, 162(7): 485-491.
7	赵延军，张红军，贾丽娟，等. 疑难肺部阴影临床与病理分析[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(1): 26-30.
8	Suzuki K, Watanabe SI, Wakabayashi M, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer[J]. J Thorac Cardiovasc Surg, 2022, 163(1): 289-301.
9	Basiri R, Sharifnezhad F, Jafarian AH, et al. Diagnostic accuracy of percutaneous transthoracic needle biopsy among peripheral pulmonary lesions: a multicenter observational study[J]. Ann Med Surg (Lond), 2024, 86(10): 5762-5766.
10	Shin YJ, Yun G, Yoon SH, et al. Accuracy and complications of percutaneous transthoracic needle lung biopsy for the diagnosis of malignancy in patients with idiopathic pulmonary fibrosis[J]. Eur Radiol, 2021, 31(12): 9000-9011.
11	Kim J, Chee CG, Cho J, et al. Diagnostic accuracy and complication rate of image-guided percutaneous transthoracic needle lung biopsy for subsolid pulmonary nodules: a systematic review and meta-analysis[J]. Br J Radiol, 2021, 94(1127): 20210065.
12	Kiranantawat N, McDermott S, Fintelmann FJ, et al. Clinical role, safety and diagnostic accuracy of percutaneous transthoracic needle biopsy in the evaluation of pulmonary consolidation[J]. Respir Res, 2019, 20(1): 23.
13	Deng CJ, Dai FQ, Qian K, et al. Clinical updates of approaches for biopsy of pulmonary lesions based on systematic review[J]. BMC Pulm Med, 2018, 18(1): 146.
14	李德珊，吴戈. 锥形束CT引导同轴穿刺在胸部肿瘤活检中的应用[J]. 介入放射学杂志，2022, 31(10): 979-981.
15	刘铄，赵金早，李思锐，等. CT模拟定位机在肺部肿瘤穿刺活检技术中的临床应用体会[J]. 中国设备工程，2024, 39(6): 231-233.
16	王莹莹，邓明友，胡蕾，等. 经皮肺穿刺活检术在肺部实性占位性病变中的诊断价值[J]. 检验医学与临床，2021, 18(10): 1479-1482.
17	邓燕云，肖国有，王国栋，等. ¹⁸F-FDG PET/CT实时导航技术对肺结节穿刺活检的应用研究[J]. 中国医疗设备，2020, 35(9): 30-34.
18	李刚，李雷. CT引导下经皮肺穿刺活检术临床应用分析[J]. 中国CT和MRI杂志，2020, 18(6): 46-48.
19	王培成，宫玉，孙殿敬. CT影像学三维重建穿刺联合消融治疗对肺部肿瘤患者活检率及生活质量的影响[J]. 中国CT和MRI杂志，2021, 19(4): 60-63.
20	牛青坡，杨庆法. CT引导下经皮肺穿刺活检术在肺部占位性病变中的诊断价值分析[J]. 临床研究，2023, 31(11): 140-142.
21	洪强，莫春生. CT引导下实性和部分实性肺结节空心针活检的诊断准确性和并发症[J]. 实用癌症杂志，2020, 35(12): 2005-2010.
22	廖如云，江宇，李晓兰，等. 对比CT引导下不同进针路径经皮肺穿刺活检效果[J]. 中国介入影像与治疗学，2021, 18(6): 335-339.
23	杨飞虎，张军豪，刘爱玲. CT与超声引导下经皮肺穿刺活检术诊断非小细胞癌与病理结果对比[J]. 中国临床医学影像杂志，2021, 32(10): 726-728，737.
24	董科，楼岑，牟达，等. PET/CT融合三维图像定位肺穿刺活检靶点的增益价值[J]. 中国医学计算机成像杂志，2020, 26(1): 64-69.
25	张文弢，任长娟，张瑞侠，等. 不同路径CT引导下经皮肺穿刺活检对孤立性肺结节诊断意义[J/OL]. 中华肺部疾病杂志(电子版), 2022, 15(2): 227-229.
26	王星，张洪，张逊. CT引导下经皮肺穿刺活检术并发症发生的影响因素分析[J]. 中国肺癌杂志，2024, 27(3): 179-186.
27	张庭秀，王琴，马李杰，等. 超声引导下经皮肺穿刺活检术术后并发症分析[J/OL]. 中华肺部疾病杂志(电子版), 2022, 15(1): 24-28.
28	Xinmiao Li, Fengxia Jin, Tao Zhou, et al. Diagnostic accuracy of CT-guided percutaneous pulmonary biopsy for distinguishing benign and malignant solitary pulmonary nodules[J]. Altern Ther Health Med, 2023, 29(8): 918-923.

临床资料	并发症(n＝51)	无并发症(n＝101)	χ²/t值	P值
吸烟史[n(%)]	28(54.90)	51(50.50)	0.264	0.608
体质量指数[n(%)]			0.857	0.355
<24.0 kg/m²	39(76.47)	70(69.31)
≥24.0 kg/m²	12(23.53)	31(30.69)
基础疾病[n(%)]			0.355	0.837
糖尿病	19(37.26)	33(32.67)
高血压	21(41.18)	46(45.55)
无	11(21.57)	22(21.78)
病灶位置[n(%)]			0.306	0.580
上/中叶	31(60.78)	66(65.35)
下叶	20(39.22)	35(34.65)
病理结果[n(%)]			0.328	0.567
阳性	33(64.71)	70(69.31)
阴性	18(35.29)	31(30.69)
病灶直径[cm，(±s)]	3.28±1.01	4.33±1.12	5.636	0.000
病灶与胸壁距离[cm，(±s)]	4.32±1.07	3.72±0.97	3.477	0.001
穿刺次数[n(%)]			1.544	0.214
1次	48(94.12)	100(99.01)
≥2次	3(5.88)	1(0.99)

临床资料	并发症(n＝51)	无并发症(n＝101)	χ²/t值	P值
吸烟史[n(%)]	28(54.90)	51(50.50)	0.264	0.608
体质量指数[n(%)]			0.857	0.355
<24.0 kg/m²	39(76.47)	70(69.31)
≥24.0 kg/m²	12(23.53)	31(30.69)
基础疾病[n(%)]			0.355	0.837
糖尿病	19(37.26)	33(32.67)
高血压	21(41.18)	46(45.55)
无	11(21.57)	22(21.78)
病灶位置[n(%)]			0.306	0.580
上/中叶	31(60.78)	66(65.35)
下叶	20(39.22)	35(34.65)
病理结果[n(%)]			0.328	0.567
阳性	33(64.71)	70(69.31)
阴性	18(35.29)	31(30.69)
病灶直径[cm，(±s)]	3.28±1.01	4.33±1.12	5.636	0.000
病灶与胸壁距离[cm，(±s)]	4.32±1.07	3.72±0.97	3.477	0.001
穿刺次数[n(%)]			1.544	0.214
1次	48(94.12)	100(99.01)
≥2次	3(5.88)	1(0.99)

检查方式		术中组织病理学		合　计
检查方式		阳性(n＝103)	阴性(n＝49)	合　计
CT-PTNB	阳性	100	2	102
	阴性	3	47	50
合　计		103	49	152

检查方式		术中组织病理学		合　计
检查方式		阳性(n＝103)	阴性(n＝49)	合　计
CT-PTNB	阳性	100	2	102
	阴性	3	47	50
合　计		103	49	152

[1]	Rui Tang, Panpan Li, Yubing Li, Ligang Cui. Quantitative assessment of muscle fat content using ultrasound computed tomography-based speed-of-sound inversion imaging: an experimental study [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(06): 564-571.
[2]	Yong Zhang, Te Ba, Jing Zhang, Lingying Liu. Research progress on the burn complications based on the gut-organ axis [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2025, 20(05): 452-457.
[3]	Jie Zhang, Zhiyang Zhang, Yong Nie, Tiemin Jiang. Technical innovations and clinical advancements in ex vivo liver resection and autotransplantation [J]. Chinese Archives of General Surgery(Electronic Edition), 2025, 19(05): 351-355.
[4]	Lijun Zhou, Jiaojiao Li, Yan Sun, Lu Wang, Rong Qian. The impact of different anastomotic methods on postoperative recovery in patients undergoing laparoscopy-assisted distal gastrectomy for gastric cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(06): 642-645.
[5]	Yi Wang, Jianqiao Kong, Peng Zhang, Yang Dai, Hengping Li. Laparoscopic ultrasound-guided duodenoscopy for the treatment of gallbladder combined with common bile duct stones [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(06): 658-661.
[6]	Chao Ma, Chuanjia Wang, Wufang Zhang. Comparative study of single-port laparoscopic breast-conserving surgery via axillary approach versus traditional open surgery for early breast cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(06): 674-677.
[7]	Chao Zhang, Jian Chang. Comparison of short-and mid-term follow-up outcomes between hybrid approach and medial-to-lateral approach in laparoscopic radical resection for right-sided colon cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(06): 685-688.
[8]	Kaiyv Jian, Ruyv Chang, Da Wang, Qianru Xu, Lin Jiang, Baolei Jia, Yuxuan Qiu, Feng Liang. A study on the short-term efficacy of different surgical approaches for advanced esophagogastric junction cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(05): 517-522.
[9]	Min Yang, Linpu Xin, Junfeng Du. A study on the preventive effect of the three-precision management plan on stoma complications after colostomy for rectal cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(05): 531-534.
[10]	Xiaona Liu, Bohui Shi, Xiaoxia Ma, Yao Chen, Na Hao. A comparative study on the impact of different surgical approaches for breast cancer on postoperative complications and rehabilitation [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(05): 551-554.
[11]	Junjun Ouyang, Bao Cai, Bing Xu. A study on the impact of transumbilical single-port and conventional laparoscopic appendectomy on children with appendicitis [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(05): 566-569.
[12]	Yinyong Deng, Jie Zhong, Lili Jiang, Jie Yang. Prediction and prevention of complications after colorectal tumor surgery: latest advances based on clinical research [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(05): 579-583.
[13]	Zhige Zhang, Zuoyou Ding, Ruizhao Dong, Jing Xu, Qiulin Zhuang, Ziang Yang. Treatment and analysis of abdominal wall defect after abdominal wall tumor resection [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(04): 401-406.
[14]	Jingying Zhang, Ying Yang, Xuehua Zeng, Xianghua Lu, Xiaojing Lyu, Shi Chen. Clinical outcomes of patients with idiopathic pulmonary fibrosis were predicted using the characteristics of quantitative CT fibrosis and emphysema [J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(05): 714-720.
[15]	Mei Wang, Yong Zhao, Jian Zhang, Lina Zhang, Jianhua Ding, Yu Cao. Predictive value of perirenal fat area measured by CT for anastomotic complications after laparoscopic intersphincteric resection [J]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(05): 367-373.

Please choose a citation manager

Content to export