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目的比较全自动式和半自动式两种活检针在CT引导下肺穿刺活检术的临床应用。
方法回顾2015年3月至2016年10月于本院进行CT引导下经皮肺穿刺活检术患者242例,其中157例使用全自动活检针(全自动组),余85例使用半自动活检针(半自动组),比较两组的穿刺成功率、充足标本率、诊断效能(准确率、敏感性和特异性)及常见并发症的发生率。
结果两组的穿刺成功率均为1000%,全自动组的充足标本率为1000%(157/157),高于半自动组的953%(81/85),差异有统计学意义(P<005);全自动组的特异度和准确率分别为917%(22/24)和981%(154/157),均高于半自动组的700%(7/10)和准确率为926%(74/81),差异有统计学意义(P<005),但全自动组和半自动组的敏感度为992%(132/133)和944%(67/71),差异无统计学意义(P>005)。全自动组针道出血的发生率为338%,高于半自动组的212%(P<005),两组气胸、血胸、痰中带血、穿刺相关感染、空气栓塞和和胸膜反应发生率的差异无统计学意义(P>005)。
结论CT引导经皮肺肿物穿刺活检术操作中,两种活检针各有优缺点,仅适用范围不同,全自动活检针充足标本率、诊断准确率和特异性更高,并发症可控,半自动活检针针道出血风险小。 相似文献
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Encor微创旋切系统对乳腺癌的诊断价值 总被引:1,自引:0,他引:1
目的分析超声引导下EnCor乳腺真空辅助旋切系统对乳腺癌的诊断价值。方法对120例经术后病理组织学检查确诊的乳腺癌患者,术前超声引导下行Encor微创旋切活检术和空心针穿刺活检术(core needle biopsy,CNB),比较2种方法的诊断符合率、漏诊率以及不同肿块大小和病理类型的诊断符合率。结果 120例乳腺癌Encor微创旋切活检术和CNB诊断符合率分别为97.5%和80.8%(P<0.05),漏诊率分别为2.5%和10.8%(P<0.01);肿块直径≤1.0 cm、1.1~2.0 cm的两种检查方法诊断符合率分别为83.8%、100.0%和44.4%、69.4%(P<0.01);肿块直径2.1~5.0 cm、>5.0 cm以及除浸润性导管癌外其他病理类型乳腺癌诊断符合率,2种检查方法比较无统计学意义。结论超声引导下Encor微创旋切活检术对乳腺癌的诊断,具有高确诊率、低漏诊率、安全、微创等优势。 相似文献
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目的评价真空辅助活检术(vacuum-assisted biopsy,VAB)与空心针穿刺活检术(core needle biopsy,CNB)对乳腺疾病的诊断价值。方法检索Pub Med、Cochrane Library、CNKI、维普数据库、万方数据库等并收集有关VAB与CNB对乳腺疾病诊断的相关文献,按预定的标准进行筛选,对纳入研究进行质量评价,并提取相应指标完成Meta分析。结果共纳入5个临床研究,包括1 741例患者。Meta分析表明,相较于CNB组,VAB组对乳腺肿瘤活检的诊断敏感性较高(P=0.003),漏诊率较低(P=0.0005),诊断低估率较低(P=0.0006);两组诊断的特异性差异无统计学意义(P=0.69)。结论对于乳腺疾病的活检VAB较CNB有更高的敏感性及更低的漏诊率和低估率。 相似文献
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超声引导下粗针活检术诊断不可触及乳腺病变的研究 总被引:7,自引:0,他引:7
目的:评价超声引导下粗针活检术(US-CNB)对不可触及的乳腺病变(NPBL)的诊断意义。方法:对138例女性患者的162处NPBL进行US-CNB和切除活检,以切除活检病理结果为诊断标准。结果:NPBL大小为3-24mm(平均11.1mm)。在US-CNB标本中,142处为良性,3处为可疑恶性,14处为恶性,3处取材不当,在手术切除标本中,18处为恶性,144处为良性。US-CNB取材不当的3处均为良性。US-CNB诊断阳性率为94.44%(17/18),特异性为100.00%(141/141),正确率为99.37%(158/159)。结论:US-CNB诊断NPBL安全、创伤小、准确率高。 相似文献
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目的:评价B超引导空芯针穿刺活检(core needle biopsy,CNB)在可触及的乳腺肿块中的临床应用价值,同时讲述操作中的技术事项。方法:回顾分析可触及肿块的乳腺疾病住院患者的临床和病理资料,总结B超引导CNB的适应证、优缺点、注意点。结果:CNB的敏感性为94.85%,假阴性为5.15%;病理低估为5.83%;诊断符合率为89.32%。14Gauge穿刺针的标本数应该是3根以上的合格标本;行ER、PR、neu检测的患者,需取合格穿刺标本4根以上。结论:对于临床可触及的乳腺肿块,该检测方法有较高的临床应用价值。B超引导CNB适用于超声发现的乳腺病灶。B超引导的CNB的优点是明显缩短手术时间和避免了手术切除肿块时可能带来的肿瘤播散。从术中冰冻病理到术前明确诊断是一种治疗模式的转变。 相似文献
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目的 探讨临床上不可触及且<1 cm的乳腺病变经超声引导下空芯针穿刺活检(CNB)诊断的准确性。方法 回顾性分析2010年1月至2015年7月行CNB及手术切除的连续124例女性患者的临床病理资料。结果 CNB诊断乳腺癌29例,良性病变95例,其中29例乳腺癌和84例良性病变患者与手术病理的诊断一致,符合率为91.1%(113/124),一致性检验的Kappa值为0.781(P<0.001)。在CNB诊断为良性病变而手术确诊为乳腺癌的11例患者中,10例为组织学低估,1例为假阴性。结论 对于<1 cm的乳腺病变进行超声引导下CNB诊断是简单且准确的方法。 相似文献
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《Clinical breast cancer》2021,21(6):532-538
ObjectivesThis retrospective study aimed to assess the value of a real-time, ultrasound-guided biopsy in evaluating internal mammary lymph nodes (IMLNs) in breast cancer.MethodsPatients who were diagnosed with breast cancer and underwent real-time, ultrasound-guided core-needle biopsy (CNB) or fine-needle aspiration (FNA) in suspected IMLN metastasis were retrospectively analyzed. Patient information and ultrasonographic images were reviewed and correlated with pathology results.ResultsOf the 164 IMLNs that were subjected to CNB, 131 were positive for metastasis by histopathologic confirmation, 8 were negative, and 25 were insufficient. By FNA, 84 IMLNs were regarded as positive for metastasis, 4 were negative, and 4 were insufficient. In total, there were 215 (83.98%) metastatic IMLNs, 12 benign IMLNs, and 29 unconfirmed by histopathology. There were statistically significant differences in the success of puncture sampling and detection of IMLN metastasis between the CNB and FNA groups (P < .05). There were no significant complications reported after FNA or CNB, including bleeding, nerve injury, infection, pneumothorax, or hemothorax.ConclusionsOur study showed that ultrasonography accurately detected nodes that were likely to be malignant IMLNs, and that real-time, ultrasound-guided CNB and FNA are accurate and valuable techniques for the determination of status in breast cancer patients. Moreover, performing ultrasound-guided CNB and FNA on suspicious IMLN metastasis does not have additional severe complications. 相似文献
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Rikiya Nakamura Naohito Yamamoto Toshiko Miyaki Makiko Itami Nobumitsu Shina Masayuki Ohtsuka 《Breast cancer (Tokyo, Japan)》2018,25(1):86-93
Purpose
The purpose of this study was to investigate the accuracy of preoperative diagnostic tools for axillary lymph nodes (LNs) staging of breast cancer.Materials and Methods
A total of 2464 consecutive patients with operable breast cancer were prospectively identified at our institution between April 2012 and March 2017. Patients with suspicious axillary LN of breast cancer were assessed using preoperative ultrasound(US) or computed tomography (CT), underwent fine-needle aspiration cytology (FNA) or core needle biopsy (CNB). The inclusion criteria for both FNA and CNB were a cortical thickness >3 mm or abnormal morphological characteristics. Patients with biopsy-proven metastasis underwent axillary lymph node dissection (ALND), and those with a negative FNA or CNB underwent sentinel lymph node biopsy (SNB). If the SNB was positive, ALND was performed. Diagnostic accuracy for SNB was calculated for both FNA and CNB. In addition, the patients in this study were divided into two groups as follows: the cN0-FNA group (suspicious LN but negative FNA) and cN0-CNB group (suspicious LN but negative CNB).Results
A number of patients with negative US/CT findings of LNs were 1406, with 744 undergoing FNA and 272 undergoing CNB for suspicious LNs. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 65, 99, 99, 80, and 85% in FNA, and 87, 100, 100, 93 and 95% in CNB, respectively. SNB was performed in 172 (cN0-CNB group) of 272 CNB and 487 (cN0-FNA group) of 744 FNA patients. One hundred and seventy-two patients from the cN0-CNB group (Tis 6, T1 97, T2 66, T3 3 patients) treated with SNB were compared to 487 from the cN0-FNA group (Tis 21, T1 225, T2 233, T3 8 patients) in terms of number of LN metastasis. A number of patients with more than 3 positive SNB and positive LNs were 9 (5%) and 0 (0%) in cN0-CNB group, and 78 (16%) and 24 (5%) in cN0-FNA group, respectively. A number of patients who had complications such as haematoma and pain at the time of 7 to 14 days after CNB and FNA were 1 (0.5%) and 1 (0.5%) in cN0-CNB group, and were 0% and 0.2% in cN0-FNA group (p = 0.44), respectively.Conclusions
The preoperative diagnosis of axillary LNs was influenced by the diagnostic tool used. CNB is a reliable method for the preoperative diagnosis of LN metastasis.13.
《European journal of surgical oncology》2019,45(7):1293-1298
BackgroundDespite the overall diagnostic utility of core needle biopsy (CNB) comparable to incisional biopsy, increased diagnostic errors have been suggested of CNB for myxoid soft tissue tumors. This study compared the diagnostic performance of CNB between myxoid and non-myxoid soft tissue tumors.Methods369 patients who underwent ultrasound-guided CNB prior to resection for soft tissue tumors were classified into two groups according to resection pathology; myxoid group (n = 75) and non-myxoid group (n = 294). One-hundred and ninety-three patients were male and the median age of the patients was 40 years. Two-hundred and sixty-three tumors were malignant.ResultsCNB correctly diagnosed malignancy in 84% (58 of 69) for the myxoid group and 95% (184 of 194) for the non-myxoid group. For diagnosing histologic grade of soft tissue sarcoma, CNB correctly identified high grade in 78% (18 of 23) for the myxoid group and 74% (94 of 128) for the non-myxoid group. Correct diagnosis rate of histological type was significantly lower in the myxoid group (63% [47 of 75] in the myxoid group and 83% [242 of 294] in the non-myxoid group, p = 0.013).ConclusionOur study suggests that CNB is useful for myxoid soft tissue tumors of the extremity, with regard to diagnosing malignancy and histologic grade. However, CNB was less useful for identifying histologic subtype in myxoid tumors than in non-myxoid tumors. 相似文献
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In Japan, fine needle aspiration biopsy (FNA) of the breast has long been recognized as a useful diagnostic tool, and has been used in many institutions because it provides a rapid, accurate and cost-effective evaluation. However, the use of core needle biopsy (CNB) is increasing, and vacuum assisted biopsy devices have been developed to produce larger specimens for analysis. CNB is useful because the frequency of inadequate specimens is lower than in FNA, and it requires a less invasive procedure than open biopsy. CNB is also more widely used, compared to FNA, because it can provide a more definitive diagnosis of borderline lesions and can be used to distinguish between IDC and ILC. Therefore, the use of CNB with mammographic or ultrasonographic guidance is especially high for non-palpable tumors. FNA is a rapid and non-invasive procedure that is useful for mass lesions. The accuracy of FNA for non-palpable lesions is relatively low, and depends upon the skill of the aspirators, cytoscreeners and cytopathologists involved in the procedure. However, FNA for palpable masses, coupled with a physical and mammographic examination (the so-called triple test) is highly accurate for diagnosis of breast cancer when all three modalities indicate malignancy, and for a benign lesion when all three are negative. 相似文献
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Usami S Moriya T Kasajima A Suzuki A Ishida T Sasano H Ohuchi N 《Breast cancer (Tokyo, Japan)》2005,12(4):272-278
Recently, the incidence of non-palpable or noninvasive breast cancer has increased. Consequently, criteria for choosing procedures to obtain pathological materials had changed. Fine needle aspiration biopsy cytology (FNA) and core needle biopsy (CNB) are both reliable procedures for detecting breast cancer. However, for non-palpable lesions, the diagnostic accuracy of CNB is higher. The main limits of FNA are the high rate of insufficient sampling and inability to determine invasiveness. CNB is an established alternative to surgical biopsy, and CNB can avoid excess surgical biopsies in a large number of patients. In addition to accurate histological diagnosis, there is interest in obtaining prognostic information from CNB, especially for patients being considered for preoperative (neoadjuvant) therapy. CNB provides useful information about histologic type and grade. However, an unavoidable problem of CNB is underestimation of invasion. On the other hand, there is good concordance in particular for estrogen receptor (ER) and progesterone receptor (PR) between CNB and surgical excision. Several aspects of CNB remains controversial, such as diagnosing papillary lesions by CNB, problems regarding tumor cell displacement after CNB, and management of lobular neoplasia (LN) on CNB. 相似文献
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Kurita T Tsuchiya S Watarai Y Yamamoto Y Harada O Yanagihara K Iida S Yamashita K Haga SS Uchida E 《Breast cancer (Tokyo, Japan)》2012,19(1):23-29