目的探讨25G活检针在诊断胸部肿块及肿块合并严重的慢性阻塞肺疾病(COPD)中的可行性及安全性。方法27例疑似胸部肿瘤患者,CT显示病灶直径为0.7～4.8cm,平均1.8cm,均在螺旋CT立体定位导引下取活检。其中15例患有严重的慢性阻塞肺疾病(COPD),1例伴有胸膜炎及陈旧肺结核,1例患凝血疾病。穿刺采用25G活检针,外面套以同轴套管行经皮取活检。标本取出后首先确定数量是否合格,然后行快速染色病理学检查。结果27例中有24例获得足够的组织学标本(88.9%),达到诊断要求者23例(95.8%),细胞学快速染色诊断17例恶性、6例良性,其中1例初始怀疑恶性者最终确定组织胞浆菌病。改用较大号活检针补充穿刺者4例,只有1例提供更进一步的诊断信息。3例出现气胸(11.1%),2例为单纯应用25G活检针者,1例为较大号针所致。结论25G活检针在诊断胸部肿瘤时具有较高的可行性和安全性,尤其对胸部肿块合并COPD患者更具有潜力。 Objective To investigate the feasibility and safety of 25G biopsy needle in the diagnosis of chest mass and mass with chronic obstructive pulmonary disease (COPD). Methods Twenty-seven patients with suspected thoracic tumors were examined by CT. The diameters of the lesions were 0.7-4.8 cm in diameter with an average of 1.8 cm. They were all biopsy guided by stereotactic spiral CT. Fifteen of them had severe chronic obstructive pulmonary disease (COPD), one with pleuritis and old tuberculosis and one with coagulopathy. Puncture using 25G biopsy needle, the outer sleeve to the coaxial cannula percutaneous biopsy. After the specimen is removed first to determine the number of qualified, and then line staining for rapid pathological examination. Results Of the 27 cases, 24 had sufficient histological specimens (88.9%), 23 (95.8%) had achieved the diagnostic criteria, 17 were malignant and 6 were benign by cytological staining, of whom 1 was initially suspected to have malignant disease Confirm histoplasmosis. Four patients were replaced with larger biopsy needles, and only one provided further diagnostic information. 3 cases of pneumothorax (11.1%), 2 cases of pure 25G biopsy needle, 1 case of larger needle. Conclusion 25G biopsy needle in the diagnosis of chest tumor with high feasibility and safety, especially for patients with chest mass in patients with COPD more potential.