精液细胞学与睾丸活检及针吸细胞学的相关性研究

为了寻找无创伤性判断睾丸生精功能及精道梗阻的检查方法，对６５例无精症患者随机分为两组：第一组６１例无精子症患者，进行精液细胞学与睾丸针吸细胞学检查；第二组１５例正常生育男性及４例无精子症患者，进行睾丸活检与精液细胞学检查。结果：第一组５３例（占８７％），精液中检出生精细胞，检出病例二者的生精细胞发育水平总符合率９１％，经χ２检验两者呈显著相关（Ｐ＜０．００５）；８例（占１３％）精液细胞学检查未见生精细胞的病例，考虑梗阻性无精子症，其中７例经精液生化指标证实，５例睾丸针吸细胞检查见精子。第二组两种方法所反映的生精细胞发育水平完全一致。说明精液细胞学检查既能很好反映睾丸生精状况，又能反映精道梗阻情况，是一种比较理想的判断睾丸生精功能及精道梗阻的无创伤性检查方法。     

无精子症病人精液细胞学与睾丸针吸细胞学检查的相关性研究

６１例无精子症病人精液细胞学与睾丸针吸细胞学研究的结果显示，８７％的病人精液中检出生精细胞；精液细胞学与睾丸针吸细胞学检查总符合率为９１％（梗阻性无精子症除外）；经ｘ￣２检验二者显著相关（Ｐ＜０．００５），同一病人两种检查所反映的生精细胞发育水平一致。提示精液细胞学检查能反映睾丸生精状况，是一种比较理想的无创伤性检查方法。     

精液,睾丸针吸细胞学与睾丸活检的相关性

对两组病例，第１组６１例无精子症病人，进行精液细胞学与睾丸针吸细胞学检查，第２组１５例正常生育男性及４例无精子症病人，进行睾丸活检与精液细胞学检查，结果显示，第１组５３例（占８７，５３／６１）精液中检出生精细胞，检出病例中精液细胞学与睾丸针吸细胞学所反是央的生精细胞发育水平总符合率为９１％，经Ｘ＾２检验二者显著相关（Ｐ〈０．００５）；８例（占１３％）精液细胞学检查未见生精细胞的病例，考虑梗阻性无精     

无精子症病人精液细胞学与睾丸针吸细胞学检查的相关性研究

６１例无精子症病人精液细胞学与睾丸针吸细胞学研究的结果显示，８７％的病人精液中检出生精细胞，精液细胞学与睾丸针吸细胞学检查总符合率为９１％（梗阻性无精子症除外）；经ｘ＾２检验二者显著相关（Ｐ〈０．００５），同一病人两种检查所反映的生精细胞发育水平一致。提示精液细胞学检查能反映睾丸生精状况，是一种比较理想的无创伤检查方法。     

多用途负压旋切活检针在睾丸活检中的应用

多用途负压旋切活检针在睾丸活检中的应用梁季鸿，洗苏，刘广钊，罗佐杰，韦敏怡睾丸活检能直接、客观地反映睾丸生精功能和精子发生状态，是男性生殖病理学研究的前提条件。为了能快速而有效地获取睾丸组织，又能最大限度地减少创伤和痛苦，我们在多年的实践中，设计和制...     

无精子症患者睾丸系统针吸检查与组织病理检查的关系

目的探讨将睾丸系统针吸检查(SFNA)与组织病理检查相结合来预测睾丸中精子存在的可能性。方法67例无精子症患者先接受睾丸切开活检术及组织病理学检查,根据活检结果将患者分为梗阻性和非梗阻性无精子症(NOA),然后进行睾丸系统针吸检查及湿片镜检来发现精子的存在。结果67例患者中梗阻性无精子症12例,非梗阻性无精子症55例。所有患者的睾丸组织病理类型分为以下几种:正常精子生成、精子生成低下、生精阻滞、唯支持细胞综合征和混合型损害。行睾丸SFNA后,49％的NOA患者中发现精子,其中组织病理类型为精子生成低下的患者具有最高的精子获取率(95％)。结论对于无精子症患者而言,睾丸系统针吸检查是在睾丸中检测精子存在的有效方法;通过该方法检测到精子的可能性与睾丸组织病理类型有密切关系。     

睾丸细针穿刺吸液细胞学检查诊断阻塞性无精子症

目的 :观察睾丸细针穿刺吸液 ( FNA)细胞学检查的效果 ,为诊断阻塞性无精子症提供新的诊断方法。方法 :2 86例无精子症患者采用睾丸 FNA细胞学检查结合精浆生化指标测定及输精管造影对睾丸生精功能及阻塞部位进行诊断 ;以 42例精子密度在正常范围 ( 2 5～ 86× 1 0 6 / ml)的成年男性作为对照组。 2 4例做钳穿活检进行自身对照。结果 :( 1 )双侧输精管未触及者 58例 ,睾丸 FNA细胞学检查生精功能正常 2 6例 (可见较多生精细胞、精子细胞及精子 )、生精功能低下 2 4例、无生精功能 8例 ,精浆果糖在正常值范围 ,而肉毒碱及α-糖苷酶明显低于正常值范围 ;( 2 ) 3 2例睾丸 FNA细胞学检查见较多精子 ,精液沉渣涂片未见生殖细胞 ,其中 6例精浆果糖、肉毒碱及 α-糖苷酶明显低于正常值范围 ,结合输精管造影确诊为射精管阻塞 ,其余 2 6例精浆果糖在正常值范围 ,而肉毒碱及α-糖苷酶明显低于正常值范围 ,确诊为附睾尾部阻塞性无精子症 ;( 3 )睾丸生精功能极度低下或无生精功能 1 96例 ,其中 1 60例仅见各级生精细胞、精子细胞和支持细胞 (睾丸生精功能阻滞 ) ,3 6例仅见支持细胞 (唯支持细胞综合征 ) ,精浆果糖、肉毒碱及 α-糖苷酶均在正常值范围 ,为非阻塞性无精子症。结论 :睾丸 FNA细胞学检查可作为阻塞性无?     

乳癌术前细针针吸细胞学选择性替代切除活检的指征探讨

目的 探讨术前应用细针针吸细胞学替代术中切除活检的指征。方法 手术治疗118例“乳房肿块”病人，术前均行临床触诊及细针针吸细胞学检查，观察诊断的灵敏度和阳性预测值。结果 细针针吸细胞学检诊乳癌灵敏度为95.7%，阳性预测值为97.1%。当触诊与细针针吸均阳性时，其联合诊断乳癌的灵敏度仅为47.8%，但联合阳性预测值却达到100％。结论 对于住院接爱手术的乳腺肿块病人，如果术前触诊能基本肯定为乳癌，则应行细针针吸细胞学检查；若针吸涂片又查到癌细胞，则可免除术中切除活检并可据此进行术前化疗。     

A sensitivity and specificity comparison of fine needle aspiration cytology and core needle biopsy in evaluation of suspicious breast lesions: A systematic review and meta-analysis

PurposeBreast cancer detections for women with suspicious lesions mainly depend on two non-operative pathological tests-fine needle aspiration cytology (FNAC) and core needle biopsy (CNB). The aim of this systematic review was to compare the sensitivity and specificity of CNB and FNAC in this setting.MethodsThe data sources included MEDLINE, EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials (CENTRAL) till February 2016. We included prospective series of studies which directly compared the accuracy of FNAC and CNB. We used forest plots to display the sensitivity and specificity of FNAC and CNB respectively. Pre-specified subgroup analyses and sensitivity analysis were conducted.ResultsUltimately, 12 articles (1802 patients) were included in the final analysis. The pooled analysis shows that the sensitivity of CNB is better than that of FNAC [87% (95% CI, 84%–88%, I² = 88.5%) versus 74% (95% CI, 72%–77%, I² = 88.3%)] and the specificity of CNB is similar to that of FNAC [98% (95% CI, 96%–99%, I² = 76.2%) versus 96% (95% CI, 94%–98%, I² = 39.0%)]. For subgroup analysis, the sensitivities of both tests are better for palpable lesions than that of non-palpable lesions. Sensitivity analysis shows the robustness of the primary analysis.ConclusionOur study suggests that both of FNAC and CNB have good clinical performance. In similar circumstances, the sensitivity of CNB is better than that of FNAC, while their specificities are similar. FNAC could be still considered the first choice to evaluate suspicious nonpalpable breast lesions.     

我国甲状腺结节细针穿刺活检技术应用现状及进展

细针穿刺活检（FNAB）作为甲状腺结节诊断的新技术,以其高敏感度和高特异度被国内外医疗工作者广泛认可。我国FNAB技术起步相对较晚,各地技术掌握水平参差不齐。纵观近10年甲状腺结节FNAB临床报道发现,我国FNAB发展具有迅猛发展、热点层出的特征,然而,在临床指征把握、穿刺取材以及结果判读上仍存在良莠不齐、有待规范等问题。因此,严格把握穿刺指征、获取满意穿刺标本和准确判读穿刺结果有助于FNAB质量控制措施的全面施行,推进甲状腺疾病迈向精准医疗时代。     

Comparison of histologic diagnosis between stereotactic core needle biopsy and open surgical biopsy

Background: This study correlates the histologic findings of stereotactic core needle biopsy (SCNB) with open surgical biopsy (OSB) and identifies which lesions can be treated definitively based only on the SCNB histology. Methods: Women who underwent SCNB between July 1, 1993, and January 1, 1969, were identified by retrospective chart review. Mammographic (MGM) lesions found by SCNB to be ductal or lobular hyperplasia with atypia, or carcinoma underwent OSB. When the histologic findings by SCNB were inconsistent with the MGM findings, the lesion also underwent OSB. Results: 799 women underwent SCNB with 96 (12%) of these going on to OSB. MGM findings in the 92 who presented without a palpable mass included microcalcifications (MCS) in 39, mass in 47, MCS and mass in 7, and tissue distortion in 3. One hundred one breast lesions biopsied first by SCNB, then by OSB were correlated histologically. Sensitivity of SCNB is 89%, with a specificity of 94%. Eight-four women (88%) were able to have definitive treatment at time of OSB because of prior SCNB, and 703/799 (88%) of women were spared OSB entirely. Conclusion: SCNB accurately identifies benign breast histology and invasive cancers in women with MGM abnormalities, a distinct advantage over fine needle aspiration cytology. SCNB does not reliably identify women with DCIS and invasion. All women with SCNB diagnosis of ductal or lobular atypia should also undergo OSB.     

肝囊腺癌的细针吸取细胞学诊断及文献复习

目的 探讨肝内胆管囊腺癌的穿刺方法 ,结合文献复习并总结其术前细胞学诊断特点.方法 2例肝脏囊实性占位患者在B超引导下行细针吸取细胞学(fine needle aspiration cytology,FNAC)检查,抽取囊液离心涂片,实质区吸取组织颗粒涂片,常规HE染色,部分吸取组织制作细胞蜡块,切片行HE染色及黏液AB染色,光镜观察,并与术后组织切片对照.结果 2例患者均未出现出血、感染等并发症,两者均抽出多量淡咖啡色及淡黄色黏稠液体,囊液未找到肿瘤细胞;实质区穿刺涂片细胞丰富,上皮细胞形成团状或乳头状,核大深染、重叠拥挤.可见细胞异型.细胞蜡块切片可见腺管状、乳头状、团状的腺上皮,细胞排列杂乱无极性,AB染色显示背景及胞质内淡蓝色黏液的存在.结合影像学及临床资料.2例FNAC诊断考虑为胆管黏液性囊腺癌(例1结合细胞蜡块切片考虑黏液性乳头状囊腺癌).穿刺诊断与术后组织切片基本一致.结论 结合影像学及临床资料,B超引导下的肝脏FNAC是术前诊断肝囊腺癌的一种安全有效的检查方法 ,制作细胞蜡块有利于诊断的进一步完善.有关肝囊腺癌与囊腺瘤的FNAC的鉴别有待进一步积累资料.     

Fine needle aspiration cytology for soft tissue tumours of the hand

The purpose of this study was to evaluate the usefulness of fine needle aspiration cytology for the preoperative diagnosis of soft tissue tumours of the hand. Fine needle aspiration cytology was performed on 93 soft tissue tumours of the hand which were classified as malignant, benign or unclassified based on cytological findings. We also attempted to make specific diagnosis by cytology. The cytological diagnosis was then compared with the postoperative histopathological diagnosis. The cytological differentiation between benign and malignant tumours showed neither false-positive nor false-negative results. Of the 47 lesions with sufficient material for cytology and that were postoperatively diagnosed histologically, 35 (including one recurrent lesion) were correctly diagnosed by fine needle aspiration cytology. No complications were encountered. Fine needle aspiration cytology has a high degree of diagnostic accuracy and safety for soft tissue tumours of the hand.     

二维超声在甲状腺细针穿刺中的应用

目的 通过对甲状腺恶性结节超声特征的筛选,探讨超声引导下细针穿刺细胞学检查对甲状腺结节术前评估的意义.方法 回顾2010年12月-2011年8月首都医科大学附属北京同仁医院耳鼻咽喉-头颈外科进行超声检查、超声引导下细针穿刺细胞学检查并行手术治疗的39例甲状腺结节患者.将超声特征、细针穿刺细胞学结果与术后病理进行对照分析,筛选恶性结节的超声特征.结果 超声引导下甲状腺结节细针穿刺细胞学的灵敏度为80.0％,特异度为89.4％,误诊率为11.0％,漏诊率为20.0％.甲状腺结节实性、纵横比≥1、钙化直径＜2mm、形态不规则、边界欠清、Ⅲ型血流等超声特征在恶性结节和良性结节中差异有统计学意义(P＜0.05).其中纵横比及形态的特异度较高,分别为90.5％及85.7％.但没有一个单独的超声特征集高灵敏度、高阳性预测值为一体可作为评估甲状腺恶性结节的指标.结论 具备任意两项特异性超声特征的结节可作为高危恶性结节进行细针穿刺,可减少实施穿刺的例数.