超声引导下乳腺肿物粗针活检的价值分析

目的 比较超声引导下乳腺穿刺活检（CNB）与开放活检病理组织学诊断的准确性,探讨CNB对乳腺肿物的诊断价值。方法 选择2014年1 月~2016年12 月在我院就诊的142例以乳腺肿块为主诉的女性患者,先行CNB,随后行开放性手术切除。对切除的标本进行病理组织学检查,比较二者的诊断符合率。结果 CNB诊断结果为浸润性癌56例,原位癌及非典型增生6例,良性病变68例,不能明确性质3例,未见明显病变9例。CNB与开放活检的诊断符合率为91.55%。结论 CNB与开放活检诊断的一致性高,对患者损伤小,结果准确可靠。     

彩超引导下甲状腺结节粗针穿刺活检的诊断意义

目的 评价彩超引导下粗针穿刺活检在甲状腺结节诊断方面的临床意义.方法 对77例甲状腺结节患者在彩超引导下行甲状腺结节粗针穿刺活检.结果 77例经皮穿刺甲状腺成功率97.4%(75/77),无并发症.临床和病理符合率为100%.结论 彩超引导下甲状腺结节粗针穿刺活检是一种安全、简便、可行的术前确诊手段.     

超声引导甲状腺结节细针穿刺针数对取材满意率的影响

目的　比较在超声引导下甲状腺结节细针穿刺活检中不同穿刺针数的标本满意率,为临床操作提供依据。 方法　纳入我院95例患者,共计106个实性或实性为主的甲状腺结节,随机分为1针组、2针组和3针组,均在超声引导下完成对甲状腺实性成分的细针穿刺活检术,标本送细胞病理学诊断,依据Bethesda分类标准,将BethesdaⅠ类定义为不满意,BethesdaⅡ~Ⅵ类定义为满意,比较不同穿刺针数的标本满意率。 结果 结节标本总体满意率为92.5%（98/106）,1针组、2针组、3针组的标本满意率分别为90.2%（37/41）、93.9%（31/33）、93.8%（30/32）,三组差异无统计学意义（P＞0.05）。 结论　对于实性或以实性为主的甲状腺结节,超声引导下细针穿刺的针数对取材的影响不明显,穿刺1针可以达到和2针、3针相当的标本满意率。     

无精子症患者附睾穿刺及睾丸活检结果分析

无精子症占男性不育病例的10％左右,其病因多不确定,治疗效果也不好。本文通过对无精子症患者经皮附睾精子抽吸术（PESA）及睾丸活检（TESE）,分析睾丸病变,为其病因分析、临床诊疗、辅助生殖等提供实验室依据。     

经皮睾丸精子抽吸术治疗无精子症的研究

目的探讨经皮睾丸精子抽吸术(PTSA)获取睾丸精子结合卵胞浆内单精子注射术(ICSI)治疗梗阻性和非梗阻性无精子症,使之获得亲生子女.方法对121例因男性梗阻性及非梗阻性无精子症患者进行诊断性穿刺,均证实有精子后进行119个周期PTSA ICSI治疗.结果共获卵子1514个,成熟卵985个,胚胎741个,平均每例6.23个胚胎,总受精率74.4%,卵裂率97.6%;共移植114个周期和冷冻胚胎移植5个周期,平均移植2.86个胚胎,B超证实临床妊娠48例,临床妊娠率40.3%.结论采用PTSA技术获取的睾丸精子进行ICSI是治疗梗阻性及非梗阻性无精子症的一种安全、简单、有效的方法.     

血清抑制素B检测对睾丸活检的预测意义

目的研究血清抑制素B水平对睾丸活检的预测意义。方法选取30例诊断为无精子症的患者,采集其静脉血测定血清抑制素B及血清FSH值,并睾丸活检确定有无精子。结果经睾丸活检确定有精子患者组与无精子患者组相比较,前者血清抑制素B水平明显高于后者,两组间有显著性差异(P0.01);前者血清FSH水平高于后者,两组间有显著性差异(P0.05)。结论血清抑制素B水平比单一的血清FSH预测睾丸活检的结局更加准确,二者结合测定,提高了预测睾丸活检结局的准确性。     

38例无精症睾丸活检的病理观察

睾丸活检对男性不育症的诊断、治疗及预后的判断有较广泛的实用价值,对计划生育工作中抗精子生成效应的组织学标准还可提供重要线索。现对1984～1985年间我院38例无精症的睾丸活检进行病理组织学观察,对适应症、病理分型、预后及有关病因等进行简要讨论。     

恶性淋巴肿瘤粗针穿刺活检的病理技术应用

淋巴瘤的定性诊断必须依靠病理学的检查.粗针穿刺活检(needle core biopsy, NCB)对患者损伤小,避免了手术切取活检造成的创伤和痛苦.本文重点介绍恶性淋巴肿瘤粗针活检的病理技术应用,现报道如下. 1 材料与方法 1.1 研究对象收集我院2003年1月～2011年12月经穿刺活检诊断的淋巴组织疾病115例,其中男性70例,女性45例,男女比为1.5:1;年龄4～83岁,平均54.3岁.     

经皮附睾或睾丸抽吸取精结合ICSI治疗无精子症

目的评价经皮附睾精子抽吸术（percutaneus epididymal sperm aspiration,PESA）或睾丸精子抽吸术（testicu1ar sperm aspiration,TESA）结合卵胞浆内单精子注射（intracytoplasmic sperm injection,ICSI）治疗无精子症的临床效果。方法对290例因男性梗阻性及非梗阻性无精子症（non-obstructive azoospermia,NOA）采用PESA或TESA穿刺获取精子,女方采用长方案超排卵,然后对处于细胞分裂中期的成熟卵母细胞进行单精予注射。结果梗阻性无精子症组203例,受精率77．5％,临床妊娠率46．1％;非梗阻性无精子症组87例,受精率73．O％,临床妊娠率41．4％,两组比较其受精率及临床妊娠率均无显著性差异（P〉0．05）。结论采用PESA或TESA获取精子结合ICSI是治疗梗阻性及非梗阻性无精子症等严重的男性不育症的一种有效的方法。     

无精子症患者睾丸生精功能与血清性激素水平的相关性分析

目的通过对广东佛山地区104例无精子症患者的血清性激素水平进行检测并分析,探讨其与睾丸生精功能的相关性。方法 104例研究对象均于我院确诊为无精子症患者,测定其血清中总睾酮(T,nmol/L)、卵泡刺激素(FSH,IU/L)、黄体生成素(LH,IU/L)、泌乳素(PRL,ng/m L)、雌二醇(E2,ng/L)水平,根据睾丸活检病理结果分为生精功能正常组(1组)、生精功能低下组(2组)、唯支持细胞综合征组(3组)。结果各组患者的年龄均无统计学差异,1组与2组患者各性激素水平无统计学差异;3组患者血清FSH、LH、PRL水平高于2组,E2水平低于2组,有显著的统计学差异,虽然3组T水平低于2组,但两组间没有统计学差异;3组患者血清FSH、LH水平高于1组,T水平低于1组,有显著的统计学差异,但两组之间的PRL、E2水平并无统计学差异。相关分析显示睾丸生精功能与T水平呈正相关,与FSH、LH水平呈负相关,与PRL、E2水平没有相关性。结论血清性激素水平测定对于预测无精子症患者睾丸生精功能有重要意义,并可用于指导治疗及判断预后情况。     

Histopathological changes in thyroid tissue after fine needle aspiration biopsy

Fine needle aspiration biopsy (FNAB) is a method that is frequently used in the diagnosis for neoplastic and non-neoplastic thyroid lesions. However, despite the contribution of this method to diagnosis, varying degrees of histopathological alterations in thyroid tissue occur due to the trauma caused by the aspiration needle. In this study, we compared the histopathology of the thyroidectomy specimens obtained by FNAB with the specimens obtained without the use of FNAB. A hundred and fifty thyroidectomy specimens obtained by FNAB were compared histopathologically with 150 thyroidectomy specimens (control group) obtained without a FNAB procedure. The thyroidectomy specimens were evaluated for hemorrhage, fibrosis, siderophagia, vascular thrombosis, vascular proliferation, infarction, granulation tissue, cystic degeneration, papillary hyperplasia, nuclear atypia, mitosis, calcification, vascular invasion, capsular distortion (pseudoinvasion), cholesterol clefts, and the presence of metaplasia. The thyroidectomy specimens obtained by FNAB had rates of hemorrhage, siderophagia, granulation tissue, papillary hyperplasia, fibrosis, calcification, capsular distortion, cholesterol clefts (P<0.001), and vascular thrombosis (P=0.001) that were statistically significantly higher than those obtained without FNAB. However, there were no clinically significant differences between the two groups in terms of vascular proliferation, nuclear atypia, mitosis, infarction, and oncocytic and squamous metaplasia. Alterations in thyroid tissue in association with FNAB show a considerable variation. Some of the alterations make diagnosis difficult, even leading to misdiagnosis in favor of carcinoma. Therefore, a thorough knowledge of possible alterations is essential to the differential diagnosis.     

Core needle biopsy versus fine needle aspiration biopsy in breast--a historical perspective and opportunities in the modern era

Breast fine-needle aspiration biopsy (FNAB) by palpation is on the decline, due to its limitations in diagnostic accuracy, decreased sensitivity, and its replacement with core needle biopsy (CNB). Despite its decreasing utility, superficial fine-needle aspiration (FNA) in breast is still the main modality for evaluating metastatic lesions, recurrence, and axillary lymph node metastasis. New modalities including proteomic pattern expression and methylation profiling of breast lesions are other promising techniques that can be used as ancillary tests for refining the diagnosis of breast lesions using FNAB. Image-guided breast FNA proves to be a successful alternative with high sensitivity and specificity. In this review, the advantages, disadvantages, and inherent limitations of breast FNA and CNB, and new advanced techniques are discussed.     

Smearing techniques for the concentration of particles from fine needle aspiration biopsy

Fine needle aspiration biopsy of palpable masses yields a variety of specimens. Some are fluid, whereas others are semisolid; some contain numerous particles, whereas others contain no identifiable particulate fragments. Not surprisingly, no single smearing technique can reasonably be expected to provide good results with such a variety of specimens. This article describes a family of techniques, of which one or more are applicable to virtually any fine needle aspiration biopsy specimen. The techniques described and illustrated include the two-step, one-step, absorption, and watch-glass techniques.     

Clinician perception of fine needle aspiration cytology

Private practitioners in San Francisco were surveyed about their perceptions of fine needle aspiration cytology. The overall response rate was 60% (369/614). The responding group was uncertain about the utility of fine needle aspiration cytology in several specific clinical settings, but 83% (307/369) believed fine needle aspiration cytology will be used more extensively in the future.     

Diagnostic value of fine needle aspiration biopsy in non-thyroidal head and neck lesions: a retrospective study of 866 aspiration materials

Aim: We aimed to investigate the diagnostic value of fine needle aspiration biopsy (FNAB) and compared our FNAB results of non-thyroidal head and neck lesions with excisional biopsy results. Materials and methods: A total of 866 aspiration material taken from different parts of head and neck region out of thyroid were evaluated at Haydarpasa Numune Training and Research Hospital Pathology Laboratory, between January 2002 and May 2013 and 248 of which has histopathologic response were included in the study. Patients depending on origin of the masses were divided into three categories as; salivary gland, lymph nodes and soft tissue/cystic lesions. The sensitivity, specificity, diagnostic accuracy values of fine needle aspiration biopsies have been investigated for all the series and individually for each category. Findings: Diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive values of non-thyroidal head and neck masses were respectively; For all of the series; 94.6%, 97.9%, 96.7%, 95.9%, 97.2%, Salivary gland: 88.9%, 100%, 98.8%, 100%, 98.7%, Lymph nodes: 94.7%, 89.3%, 92.9%, 94.7%, 89.2%, Soft tissue/cystic lesions: 100%, 100%, 100%, 100%, 100%. For all of the series; there were 4 false negative (FN) cases; and 3 false positive (FP) cases. Conclusion: FNAB in the diagnosis of head and neck masses; it is an easy, cheap and usefull procedure.     

Role of immunocytochemistry in diagnosis of prostatic neoplasia by fine needle aspiration biopsy

The efficacy of immunocytochemical staining for prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP) was studied in aspiration biopsy specimens from 19 patients. Eighteen patients had prostatic carcinoma and one had hyperplasia of prostate. Specimens were obtained from both the primary tumors and metastatic sites. Immunoperoxidase staining was performed on alcohol-fixed cytology smears (some prepared up to 9 years previously) using appropriate antisera followed by an avidin-biotinylated horseradish peroxidase complex. Results were scored according to the percentage and intensity of positively stained malignant cells. Corresponding histologic specimens were stained and scored in a similar fashion. Correlations were made between the staining characteristics of the tumor markers and grade of tumor, using the University of Texas M.D. Anderson Hospital classification of prostate carcinoma. Overall there was good correlation between cytologic and histologic specimens for the presence of PSA and PSAP, although metastases tended to show fewer positively stained cells than the primary tumor. There was no relationship between tumor grade and percentage of positively stained cells. Ninety-three percent of aspirated primary and secondary prostatic tumors stained positively for PSAP compared with 81% for PSA. In one of 3 patients, negative staining of neoplastic cells by both PSAP and PSA was helpful in confirming the existence of a second primary tumor.