针刺快速细胞学诊断在肺及纵隔肿瘤手术中的应用

探讨细针穿刺细胞学诊断在肺及纵隔肿瘤手术中的应用价值。方法，对７９例肺中肿块，１２例纵隔肿瘤术中应用细针穿刺细胞学诊断，并与术后病理结果对照。结果：肺部肿块细胞学诊断准确率为９７．５％（７７／７９），细胞类型诊断准确率为９３％（）５５／５９），纵     

细针穿刺细胞学检查在乳腺肿块诊断中的意义

通过对826例乳腺肿块细针穿刺细胞学(FNAC)检查与临床组织病理的比较,分析两者之间的相关性,同时对62例两者之间不符病例进行回顾性分析。     

细针吸取细胞学在甲状腺肿块术前诊断中的应用

目的:探讨细针吸取细胞学在甲状腺肿块术前诊断中的应用价值。方法:采用细针吸取细胞,以5ml~10ml一次性塑料注射器,1ml~3ml负压,在甲状腺肿块处来回快速抽吸2次~3次,把吸取物涂片1张~2张,95%酒精固定,H.E染色。结果:选择有病理组织学对照的175例病例,细胞学诊断与组织学诊断完全符合108例,基本符合38例,符合率83.4%,不符合29例,占16.6%。结论:细针吸取细胞学对区别甲状腺肿块的良恶性,明确诊断某些甲状腺疾病不失为一种简便、安全、可靠的诊断方法。     

针吸细胞学在肺部肿瘤手术中快速诊断及与体外肺部肿瘤穿刺…

本文对６９例肺部肿瘤剖胸后进行快速细胞学诊断及对１２例肺部肿瘤经皮细针穿刺细胞学结果显示，前者细胞学诊断符合率为９８％，假阴性率为各种恶性肿抗后者细胞学诊断率为６４％，假阴性率为３６％，二者细胞学分型符合率为８８％和７１％，差别无显著性，提示：剖胸后肺部肿瘤穿刺快速细胞学诊断，能指导手术者采取更合理的手术方式，最大限度地切除病变和保留正常组织器官与功能，提高患者生存质量。     

经皮细针胸腔肿块穿刺细胞学诊断

目的 经皮细针胸腔肿块穿刺做细胞学诊断。方法 193例经皮细针胸腔肿块穿刺细胞学诊断。结果 诊断总符合率92.2％,敏感性93.3％,特异性98.4％,恶性肿瘤的诊断符合率91.3％,敏感性92.7％,特异性98.7％。鳞癌和腺癌的符合率分别为65.6％和76.5％。结论 经皮细针胸穿细胞学诊断率高,腺癌和鳞癌分类较不理想。提高正确诊断性的关键是获取足够的细胞量和训练有素的细胞学者注意结合临床表现。     

细针吸取细胞学在甲状腺肿块术前诊断中的应用

目的:探讨细针吸取细胞学在甲状腺肿块术前诊断中的应用价值.方法:采用细针吸取细胞,以5ml～10ml一次性塑料注射器,1ml～3ml负压,在甲状腺肿块处来回快速抽吸2次～3次,把吸取物涂片1张～2张,95%酒精固定,H·E染色.结果:选择有病理组织学对照的175例病例,细胞学诊断与组织学诊断完全符合108例,基本符合 38例,符合率83.4%,不符合 29例,占16.6%.结论:细针吸取细胞学对区别甲状腺肿块的良恶性,明确诊断某些甲状腺疾病不失为一种简便、安全、可靠的诊断方法.     

经皮细针肺穿刺细胞学检查对肺癌的诊断价值

目的：对初步诊断为肺癌的非手术病例行经皮细针肺穿刺术，寻求病理支持。方法：CT定位应用7号细长针取材，涂片送细胞学检查。结果：76例中确诊肺腺癌45例。鳞癌6例，小细胞癌3例，未定型癌16例，不能确诊6例，阳性率为92．1％(70／76)。结论：经皮细针肺穿刺细胞学检查诊断肺癌阳性率高，有推广价值。     

肺、纵隔细针穿刺应用及病理分析

目的 分析秦氏穿刺针在肺及纵隔病变检测中的应用及病理诊断状况。方法 选用秦氏穿刺针中的Ⅲ型槽式穿刺针对１６０例肺、纵隔病变进行穿刺活检作病理切片分析，观察其阳性检测率、准确率、假阳性及假阴性率，同时对所得标本进行病理分类。结果 所有病例穿刺未发生重大并发症，阴性结果７例，组织太少不足诊断８例，怀疑恶性１６例，明确诊断１２９例（肿瘤１１９例，炎症１０例），检测率（包括怀疑恶性）为９０．６％，明确诊断     

针吸及印片细胞学在乳腺肿块诊断中的意义

目的 提高乳腺肿块细胞病理学检查的准确性。方法 对33l例乳腺肿块细针吸取细胞学检查(FNAC)、术中印片与其术后病理组织学诊断对照分析。结果 136例乳腺恶性肿瘤，FNAC确诊率86％(117／136)，假阴性率3．7％(5／136)，无假阳性诊断。195例良性病变，FNAC确诊率94．9％(185／195)。诊断符合率95．5％。术中印片纠正5例假阴性诊断，22例可疑病变得到确诊，印片对恶性肿瘤的确诊率为98．50%，诊断符合率达100％。结论 FNAC、印片是乳腺肿块之便捷、有效的辅助诊断方法，能部份替代乳腺癌术前或术中活组织检查。重视体检，掌握临床资料，采取FNAC与术中印片相结合，可减少误漏诊。     

Accuracy of Fine Needle Aspiration Cytology from Breast Masses in Thailand

Objective: To evaluate the accuracy and diagnostic performance of fine needle aspiration FNA cytology indiagnoses of breast masses. Methods: Women who had FNA diagnoses for breast masses and underwentsubsequent histopathologic evaluation during January 2003-December 2006 were accessed from the archive ofthe Anatomical Pathology Department of our institution. Cytologic diagnoses were classified as unsatisfactory,benign, atypical probably benign, suspicious probably malignant, and malignant, and were compared to thehistopathologic diagnoses obtained from core needle biopsy, excisional biopsy, or mastectomy to give an assessmentof the diagnostic performance of FNA. Results: A series of 190 breast masses were identified during the studyperiod. The FNA cytological diagnosis was unsatisfactory due to inadequate specimens in eight cases (4.2%).The diagnoses in the remaining 182 cases were: benign lesions in 98 (53.9%); suspicious for malignancy in 31(17.0%); and malignant in 53 (29.1%). From the subsequent histopathologic diagnoses, 6/98 cases of benigncytology turned out to be malignant lesions (false negatives); 22/31 cases of suspicious cytology were trulymalignant while the other nine were benign; and only 1/53 with malignant cytology was benign (false positive),the lesion being a fibroadenoma . The overall accuracy, sensitivity, specificity, positive predictive value, andnegative predictive value were 91.2% (95% confidence interval [CI], 87.6%-94.8%), 92.5% (95% CI, 88.7%-96.3%), 90.2% (95% CI, 85.9%-94.5%), 88.1% (95% CI, 83.4%-92.8%) and 93.9% (95% CI, 90.4%-97.4%),respectively. Conclusions: FNA cytology is highly accurate for diagnosis of breast masses. However, the clinicianshould correlate FNA cytological results with physical examination and imaging findings to prevent false negativeand false positive events and to obtain optimal management for their patients.     

乳腺肿物细针穿刺细胞学诊断的研究

目的　对细针穿刺细胞学诊断在乳腺肿物穿刺中的应用进行评价。方法　细针穿刺乳腺触及到实变处肿物吸取组织细胞涂片 ,采用瑞氏 -姬姆萨复合染色 ,显微镜下观察细胞排列、结构、背景特点、细胞形态等方面对乳腺肿物良恶性判定 ,并与病理组织学诊断进行对比分析。结果　乳腺肿物 3 3 2 5例细针穿刺 ,总准确率为 98 1% ;65 5例乳腺癌的诊断准确率为 10 0 % ;在部分良性病例 (乳腺纤维腺瘤 )的诊断准确率为 88% ;疑癌 94% ,描述性报告 7%确诊为乳腺癌。结论　细针穿刺细胞学诊断对于临床诊断良恶性病变有独到价值。且对恶性病例诊断更为可靠。此诊断技术简便 ,费用低 ,值得推广应用。     

Intraoperative fine needle aspiration cytology of pancreatic lesions

The aim of the present study was to demonstrate the practicality of intraoperative fine needle aspiration (FNA) cytology of pancreatic lesions in 43 patients. The indication for performing this procedure was to determine the nature of pancreatic masses. Conclusive cytologic diagnoses were reached in 41 patients who represent the present study. On the basis of histologic findings in 30 cases (73.2%) and on clinical findings in 11 cases (26.8%), a final diagnosis of malignant pancreatic disease (MPD) was established in 31 and of benign pancreatic disease (BPD) in 10 patients. Among the 31 cases with MPD, the cytologic diagnosis was correct in 30 patients and falsely negative in one patient. Among 10 patients with BPD, all the cytologic finding were reported as benign. The sensitivity and specificity and positive and negative predictive values for cytologic findings were 96.8%, 100%, 100%, and 90.9%, respectively. The diagnostic accuracy of FNA cytology was 97.6%. No complications followed the procedure. We conclude that intraoperative FNA cytology of pancreatic lesions is a simple, safe, highly sensitive, and specific tool in differentiating benign from malignant pancreatic lesions. This procedure should be carried out in any patient with pancreatic mass incidentally found at laparotomy or in a patient undergoing surgery because of suspected nonmetastasizing MPD in whom repeated imaging guided FNA failed to demonstrate malignancy.     

模拟定位机导引下经皮细针吸取活检对肺部肿块的诊断意义

目的　探讨模拟定位机导引下经皮细针吸取活检对肺部肿块的诊断意义。方法　应用模拟定位机导引下经皮细针吸取肺部肿块活检对 175例肺部肿块的诊断价值进行分析。结果　共获得细胞学标本 16 9例 ,活检成功率 96 6 % (16 9/175 ) ,诊断阳性率92 % (16 1/175 ) ,并发症率 6 3 % (11/175 ) ,假阴性率 4 7% (8/16 9)。本组恶性肿瘤占 90 1% (14 5 /175 ) ,可进行病理分类 77 9% (113/14 5 )。良性病变 9 94% (16 /175 )。结论　模拟定位机导引下经皮细针吸取肺部肿块活检对肿块的定位、测量深度及确定进针方向比电透、B超及CT导引下肺穿刺活检有较多的优越性 ,特别对肺内 1 5～ 3cm的小肿块的针吸肺活检更具有诊断价值     

经支气管针吸淋巴结活检(TBNA)在非小细胞肺癌新辅助化疗纵隔再分期中的作用

背景与目的 评估经支气管针吸淋巴结活检(TBNA)在EA-N2期非小细胞肺癌新辅助化疗纵隔再分期中的特异性和敏感性.方法 对连续的21名组织细胞学证实的NA-N2期非小细胞肺癌患者给予新辅助化疗后行经支气管纵隔淋巴结针吸活检、再分期.所有患者行化疗前后CT对比,其中15例病变无明显变化,6例部分好转.所有患者行根治性切除及淋巴清扫术.结果 经支气管针吸淋巴结活检(TBNA)证实13例(62%)仍存在纵隔转移淋巴结.8例未检出转移淋巴结,其中手术标本病理分期仍有7例为ⅢA-N2期.假阴性结果中的大部分(6例,8696)是由于穿刺标本未检出所致.经支气管针吸活检(TBNA)在ⅢA-N瑚非小细胞肺癌新辅助化疗纵隔再分期中的总的敏感性、特异性、阳性预测值、阴性预测值、诊断准确率分别为6596、100%、100%、12.5%、66%.结论 经支气管针吸淋巴结活检(TBNA)对于非小细胞肺癌(NSCLC)新辅助化疗纵隔再分期是一种较高敏感性,高特异性,准确,微创的检测方法.但因阴性预测值较低,所以阴性病例应结合纵隔镜等方法行外科分期.     

323例乳腺肿块针吸细胞学诊断分析(英文)

目的探讨乳腺癌针吸细胞学(FNAC)诊断准确性。方法分析1326例乳腺肿块针吸细胞学诊断,并与323例手术后病理组织学诊断结果对比。结果本组 FNAC 诊断敏感性为97.1%,特异性为97.3%,假阳性率为2.7%,假阴性率为2.9%,诊断符合为97.2%。结论乳腺肿块 FNAC 检查是一种实用价值很高的诊断方法。文中对影响 FNAC 诊断的因素进行了讨论。     

323例乳腺肿块针吸细胞学诊断分析

目的 探讨乳腺癌针吸细胞学(FNAC)诊断准确性。方法 分析1326例乳腺肿块针吸细胞学诊断,并与323例手术后病理组织学诊断结果对比。结果 本组FNAC诊断敏感性为97.1％,特异性为97.3％,假阳性率为2.7％,假阴性率为2.9％,诊断符合为97.2％。结论 乳腺肿块FNAC检查是一种实用价值很高的诊断方法。文中对影响FNAC诊断的因素进行了讨论。     

37例猫抓病细针吸取细胞病理学分析

[目的]探讨细针吸取细胞病理学(FNAC)检查对猫抓病诊断的价值及细胞病理学特点。[方法]回顾37例猫抓病的FNAC资料,并与其中21例行手术活检的病理结果进行比较。[结果]FNAC对猫抓病的定性准确率为94%,其细胞病理学特点主要表现为肉芽肿并脓肿样改变。13例患者FNAC和手术活检均诊断为猫抓病。[结论]FNAC对猫抓病的诊断准确率高,细胞病理学特点明确,利于减少不必要的手术活检。     

Detection of B-Cell Monoclonality in Fine Needle Aspiration by PCR Analysis

Cytologic examination of fine-needle aspiration (FNA) sometimes fails to diagnose the malignant nature of B-cell proliferations. In this study we analyzed the Ig gene rearrangement of 49 FNA samples by polymerase chain reaction (PCR) in order to evaluate whether molecular analyses can improve the accuracy of FNA. Twenty-six patients had non-Hodgkin's lymphoma, 11 had reactive lymphoid diseases, 5 had chronic inflammation and 7 had carcinoma. A semi-nested PCR was performed using an oligoprimer specific for consensus sequences of the V regions (FR3A) and two oligoprimers derived from conserved sequences of the J regions (LJH and VLJH). Histologic examination always followed the molecular and cytologic analysis. The sensitivity of PCR and FNA morphological examination in detecting a neoplastic pattern was 92% and 78%, respectively. When samples were considered inadequate for cytologic examination, PCR always reached a diagnosis consistent with the histologic features. Our results demonstrate that PCR analysis of FNA specimens is a reliable and sensitive method capable of enhancing the diagnostic accuracy of cytologic examination.     

乳腺恶性淋巴瘤细针吸取细胞学诊断

目的讨论细针吸取细胞学诊断乳腺恶性淋巴瘤病例的细胞形态学特征，鉴别诊断和诊断价值。（方法）对7例患者的临床、病理及细胞学资料进行回顾性分析。（结果）在4918例乳腺肿瘤病例中，发现7例恶性淋巴瘤，占乳腺恶性肿瘤的1．08％（7／647）。7例均为非何杰金淋巴瘤，对照分析其细胞学、组织学及超微结构等形态学表现，证明细胞学结果是可靠的。（结论）细针吸取细胞学诊断乳腺恶性淋巴瘤具有安全、方便和可重复性等优点，诊断时需与良性淋巴组织增生、小细胞未分化癌和具有浆细胞样特征的腺癌鉴别。