| Abstract | Transtorakalna biopsija je minimalno invazivna, radiološka metoda u dijagnostici perifernih i paracentralnih plućnih lezija. Pod vodstvom slikovnih metoda, najčešće CT-a, pomoću biopsijske igle pribavlja uzorak za citološku i patohistološku analizu. CT pruža mogućnost za vizualizaciju čitavog toraksa, preciznu lokalizaciju ciljne lezije, pouzdan prikaz biopsijske igle tijekom pretrage te omogućuje ranu detekciju komplikacija. Glavne prednosti ove metode su precizno uzimanje tkiva iz lezije, relativna sigurnost postupka, skraćen boravak u bolnici i mali broj komplikacija. Metoda omogućuje sigurnu dijagnozu koja je neophodna za odabir liječenja.
Ciljevi ovog istraživanja su utvrditi učestalost karcinoma ne-malih stanica u pacijenata koji su podvrgnuti CT-om vođenoj TTB, odrediti učestalost tri patohistološka tipa NSCLC te odrediti najučestaliji podtip, odrediti najčešću komplikaciju dijagnostičkog postupa te odrediti senzitivnost i specifičnost metode.
U istraživanje je uključeno 57 pacijenata oba spola i dobi. Analiziran je i pušački status ispitanika. Istraživanje se provelo pretraživanjem i analizom podataka iz IBIS-a te su izdvojeni pacijenti s karcinomom ne-malih stanica, analizirala se učestalost podtipova NSCLC, te su izdvojene komplikacije dijagnostičkog postupka CT-om vođena TTB. Utvrđena je senzitivnost i specifičnost metode.
U istraživanje je uključeno 57 pacijenata podvrgnutih TTB vođenu CT-om. Od 57 pacijenata, bilo je 70,2% muškaraca i 29,8% žena. Pušača je bilo 33,33%, bivših pušača 19,30%, ne pušača 14,04% te za 33,33% pacijenata nije bilo podataka o pušenju. 82,46% pacijenata imalo je pozitivan patohistološki nalaz, dok je 17,54% imalo negativan. Od toga najčešće dijagnosticirani tip karcinoma ne-malih stanica bio je adenokarcinom (44,68%), drugi najčešći bio je planocelularni (27,66%), a karcinom velikih stanica nije imao niti jedan pacijent. U preostalih 27,66% pacijenata bile su dijagnosticirane ostale maligne bolesti. Najčešća komplikacija bila je pneumotoraks (35,09%), pneumotoraks zajedno s plućnim krvarenje pojavio se u 5,26% pacijenata, a plućno krvarenje u svega 3,51%. Visok postotak pacijenata (56,14%) bio je bez komplikacija. Senzitivnost dijagnostičke metode iznosi 72,34%, a specifičnost je 100%.
Zaključeno je kako su najučestaliji dijagnosticirani karcinomi pluća ne-malih stanica te je adenokarcinom najučestaliji patohistološki podtip. Najčešća komplikacija je pneumotoraks, ali je više od polovice pacijenata bilo bez komplikacija nakon postupka. Metoda ima visoku senzitivnost i specifičnost te je vodeća metoda u verifikaciji plućnih lezija. |
| Abstract (english) | Transthoracic biopsy is a minimally invasive, radiological method in the diagnosis of peripheral and paracentral pulmonary lesions. Under the guidance of imaging methods, most often CT scans, it uses a biopsy needle to obtain a sample for cytological and pathohistological analysis. CT provides an opportunity to visualize the entire thorax, accurately localize the target lesion, reliably display the biopsy needle during the search, and allow for early detection of complications. The main advantages of this method are the precise taking of the lesion, relative safety, shortened hospital stay and a reduced number of complications.
The objectives of this study were to determine the incidence of non-small cell cancer in patients undergoing TTB-guided CT, to determine the frequency of three pathohistological types of NSCLC and to determine the most common subtype, to determine the most common complication of diagnostic treatment, and to determine the sensitivity and specificity of the method.
The study included 57 patients who, due to peripheral localization of the lungs suspected of malignant, underwent a TTB-guided CT scan for diagnosis of the disease and type of malignoma. Patients of both sexes and ages and smoking status were included in the study. The study was also carried out by analyzing data from the IBIS and singled out patients with non-small cell cancer, the frequency of subtypes of NSCLC was analyzed and the complications of the TTB-guided diagnostic procedure were singled out. The sensitivities and specificity of the method were established.
The study included 57 patients undergoing CT-guided TTB. Of the 57 patients, there were 70.2% male and 29.8% female. Smokers were 33.33%, former smokers 19.30%, non-smokers 14.04% and 33.33% of patients had no smoking data. 82.46% of patients had a positive pathohistological report, while 17.54% had a negative one. Of these, the most commonly diagnosed type of non-small cell carcinoma was adenocarcinoma (44.68%), the second most common was squamous cell (27.66%), and no patients had cancer of large cells. In the remaining 27.66% of patients, other malignant diseases were diagnosed. The most common complication was pneumothorax (35.09%), pneumothorax together with bleeding occurred in 5.26% of patients, and bleeding in only 3.51%. A high percentage of patients (56.14%) were without complications. The sensitivity of the diagnostic method is 72.34%, and the specificity is 100%.
It was concluded that non-small cell lung cancers are the most frequently diagnosed and adenocarcinoma is the most common pathohistological subtype. The most common complication is pneumothorax, but more than half of the patients were without complications after the procedure. The method has a high sensibility and specificity and is a leading method in the verification of pulmonary lesions. |
