[Diagnostic accuracy research of needle puncture biopsy during operation for pulmonary single nodules].
OBJECTIVE
To investigate the diagnostic accuracy of needle puncture biopsy and pathological examination of frozen during operation for pulmonary nodules, and whether this diagnostic method can replace tumor resection examination.


METHODS
Totally 50 patients (28 males and 22 females, average age was 59 years) who had the single nodule after imaging examination without any pathological diagnostic from January to October 2010 were selected in this research work. During open operation or video assisted thoracic surgery, needle (14 G model) was used to puncture biopsy for pathological examination of frozen. All the adverse events during puncture biopsy would be recorded. The resection specimens would be accepted paraffin pathological examination. The relationship between puncture frozen pathological and paraffin pathological examination was analyzed.


RESULTS
All tumor sizes were ranged from 1.0 cm × 0.6 cm to 5.6 cm × 9.0 cm. The paraffin pathological examination after operation as the golden standard, there were 7 cases of benign tumor and 43 cases of malignant tumor. The diagnostic sensitivity of puncture biopsy was 90.7%, the specificity was 100%, the positive predictive value was 100% and the negative predictive value was 63.6%. There were 11 cases of benign tumor diagnosed by needle puncture biopsy, among which 4 cases were proved as malignant tumor by paraffin pathology, and the false negative rate was 9.3%. The main risk of puncture biopsy was bleeding after puncture immediately, and the rate was 4.0% (2/50).


CONCLUSIONS
The puncture biopsy during operation had a high specificity for malignant lung tumor, and there was a certain false negative rate for benign tumor. Puncture biopsy and pathological examination of frozen tissue can replace tumor section biopsy in a way.
Department of Thoracic Surgery, Key Laboratory of Carcinogenesis and Translational Research of Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing Cancer Hospital, Beijing 100142, China.
Jin-feng
JF
Chen
Yi-nan
YN
Liu
Nan
N
Wu
Yuan
Y
Feng
Jia
J
Wang
Chao
C
Lü
Yu-zhao
YZ
Wang
Yu-quan
YQ
Pei
Shi
S
Yan
Qing-feng
QF
Zheng
Li-jian
LJ
Zhang
Yue
Y
Yang
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007430:Intraoperative Care; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity