摘要

Fine-needle biopsy (FNB) is associated with problems, such as tumor seeding, which are probably underestimated. The aim of this study was to validate prospectively the accuracy of our diagnostic work-up without FNB, for defining indications for surgery in a cohort of patients with focal liver lesions (FLLs). Between January 1997 and December 1998, 160 consecutive patients carrying 225 FLLs admitted to our department were evaluated prospectively. Preoperative diagnoses were established by means of clinical histories, serum tumor marker levels, ultrasonography, and spiral computed tomography (CT). Angiography, magnetic resonance imaging (MRI), and Lipiodol-CT were performed when it was considered necessary to plan the surgical strategy. All the patients underwent surgery and results of pathological examinations were obtained for all of them. The preoperative diagnoses of 221 of the 225 lesions (98.2%) were confirmed, and the indications for liver resection in 156 of the 160 patients (97.5%) were correct. The respective accuracy, sensitivity, specificity, and positive and negative predictive values were 99.6%, 100%, 98.9%, 99.3%, and 100% for diagnosis of hepatocellular carcinoma (HCC); 99.1%, 100%, 98.8%, 96.9%, and 100% for metastases; 99.6%, 100%, 99.5%, 91%, and 100% for cholangiocellular carcinomas (CCCs); all 100% for mixed HCC-CCCs; and 98.7%, 57.1%, 100%, 100%, and 98.6% for benign tumors. In view of these results, the fact that the real risks of FNB have yet to be established and the possibility that tumor seeding has a major impact on patient prognosis, the use of FNB should be drastically limited.

译文

细针活检 (FNB) 与肿瘤播种等问题相关,这些问题可能被低估。本研究的目的是前瞻性地验证我们在没有 FNB 的情况下进行诊断检查的准确性,以确定肝脏局灶性病变 (FLLs) 患者队列中的手术指征。在 1997年1月至 1998年12月期间,我们对 160 名连续携带 225 个 FLLs 的患者进行了前瞻性评估。通过临床病史、血清肿瘤标记物水平、超声检查和螺旋计算机断层扫描 (CT) 建立术前诊断。当认为有必要计划手术策略时,进行血管造影、磁共振成像 (MRI) 和碘油 CT。所有患者都接受了手术,并获得了病理检查结果。221 个病灶中 225 个 (98.2%) 的术前诊断得到证实,156 个患者中 160 个 (97.5%) 的肝切除指征是正确的。诊断肝细胞癌 (HCC) 的相对准确性、敏感性、特异性以及阳性和阴性预测值分别为 99.6% 、 100% 、 98.9% 、 99.3% 和 100%; 99.1% 、 100% 、 98.8% 、 96.9% 和 100% 为转移; 99.6% 、 100% 、 99.5% 、 91% 和 100% 为胆管癌(CCCs); 混合 HCC-CCCs 的所有 100%; 良性肿瘤的 98.7% 、 57.1% 、 100% 和 98.6%。鉴于这些结果,FNB 的真正风险尚未确定以及肿瘤播种对患者预后有重大影响的可能性, FNB 的使用应该受到极大的限制。

Fine needle biopsy

内分泌 活检技术 诊断技术
概述  :  

细针穿刺是一种活组织检查技术。在细针抽吸中,将细针插入异常出现的组织或体液区域。与其他类型的活组织检查一样,在细针抽吸过程中收集的样本可以帮助诊断或排除癌症等疾病。细针穿刺通常被认为是安全的技术,并发症很少发生。适应症囊肿(充满液体的肿块);结节或肿块(实心肿块);淋巴结肿大。注意事项在活检前几天停止服用抗凝药物,如华法林(香豆素)或阿司匹林。在手术前不要进食或饮水。在某些情况下,在针吸活检前接受静脉注射(IV)镇静剂或全身麻醉剂。如果是这种情况,在手术前一天禁食。并发症细针穿刺后严重的并发

fine   英 /faɪn/

释    义   adj. 优质的;令人满意的;健康的;天气晴朗的

               adv.(非正式)令人满意地;在三柱门后面;(切得)细小地

               n. 罚金;优质法国白兰地酒;上等白兰地酒;(音乐指挥用语)终止

               v. 处……以罚金;澄清;(液体)变纯,变清;(使)变细,变瘦

同根词   finable adj. 应罚款的;可提炼的;可精制的

               finely adv. 非常地;细微地;美好地;雅致地

               fineness n. 美好;纯度;细微;优雅

例    句   If you keep on working hard like this, you will do fine in any other company. 如果你继续这样努力工作,你在任何别的公司都能干得很好。

 

needle   英 /'niːd(ə)l/   美 /'nidl/

释    义   n. 针;指针;刺激;针状物

               vi. 缝纫;做针线

               vt. 刺激;用针缝

同根词   needled adj. 针刺的

               needled v. 用针缝;穿行(needle的过去分词)

例    句   They inserted the microchip through a needle. 他们插入该芯片通过一个针。

 

biopsy   英 /'baɪɒpsɪ/   美 /'baɪɑpsi/

释    义   n. 活组织检查;活组织切片检查;切片检查法

例    句   If this is the case, you may need to have a cone biopsy. 如果是这样的情况下,您可能需要有一个锥活检。

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