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入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１６９例，活检成功率９６．６％（１６９／１７５），诊断阳性率９２％（１６１／１７５），并发症率６．３％（１１／１７５），假阴性率４．７％（８／１６９）。本组恶性肿瘤占９０．１％（１４５／１７５），可进行病理分类７７．９％（１１     

CT导引细针活检定性诊断肺小病灶

对痰细胞学及纤维支气管镜检查不能确诊的肺周边部小病灶,行ＣＴ导引细针肺活检,以期术前定性诊断,并发现早期肺癌。方法收集痰检及纤支镜检不能确诊的≤２ｃｍ的肺周边部小病灶２４例,使用Ｓｏ－ｍａｔｏｍＤＲ－Ｈ型ＣＴ机薄层扫描定位,２０Ｇ活检针在胸部病灶定位尺指导下穿刺取材,行细胞及组织病理学诊断。以术后病理诊断及２年临床观察结果为判定标准,分别统计细胞学、组织学诊断的准确性。结果恶性病变１６例,良性８例。细胞学诊断灵敏度为７５．０％（１２／１６）,特异度为８／８,准确度８３．３％（２０／２４）;组织学诊断灵敏度为８７．５％（１４／１６）,特异度为８／８,准确度９１．６％（２２／２４）,并发现早期肺癌２例。结论ＣＴ导引细针肺活检安全,准确,诊断迅速,并可发现早期肺癌,值得推广。     

彩超引导下门静脉癌栓细针穿刺活检术在门静脉癌栓的诊断和疗效评价中的价值(附25例报告)

目的探讨彩超引导下门静脉癌栓穿刺活检术在门静脉癌栓的诊断和疗效评价中的价值。方法２５例患者接受肝动脉栓塞化疗和门静脉化疗，在治疗前后分别行彩色超声多普勒引导下门静脉癌栓细针自动活检术，对活检标本进行总结分析。结果（１）穿刺取材成功率为１００％，无明显并发症，均可作出满意的病理诊断。（２）治疗前癌栓内均有血流频谱，活检病理为增殖型，细胞呈条柱状排列。治疗后３周，４例（１６．０％）患者癌栓内多普勒血流频谱消失，相应活检病理证实癌栓坏死，其中２例获二期切除；２１例（８４．０％）治疗后癌栓无明显改变。结论彩色多普勒超声引导下门静脉癌栓穿刺活检安全准确，取材迅速可靠，对门静脉癌栓的诊断和指导治疗均有重要意义。     

前列腺穿刺患者前列腺癌检出率及其与 PSA、年龄的相关性

目的：探讨前列腺穿刺患者前列腺癌检出率情况,并分析其与前列腺特异性抗原（prostate specific an-tigen,PSA）、年龄的相关性。方法：回顾性收集2009年1月至2015年12月自贡市第一人民医院收治的年龄≥50岁且符合前列腺穿刺活检指征患者232例,对患者行 PSA 检测、直肠指诊（digital rectal examination,DRE）和经腹前列腺超声、MRI 检查,计算前列腺癌的检出率,分析前列腺癌检出率与年龄、PSA 水平的相关关系。结果：本组232例穿刺活检患者中,病理诊断为前列腺癌74例,阳性检出率为31．9％（74／232）。74例患者中,高分化癌16例（21.6％）、中分化癌24例（32．4％）、低分化癌34例（45．9％）。PSA 值＜4μg／L、4．1～10μg／L、10．1～20μg／L、＞20μg／L 4组患者前列腺癌检出率分别为9．1％、13．0％、16．2％、52．3％,随着 PSA 值的增加,前列腺癌检出率增长明显,呈明显的上升趋势（P ＜0．001）。随着年龄增高,PSA 值也越大,差异有统计学意义（Z ＝－3．328,P ＜0.001）;年龄＜60岁、60～69岁、70～79岁、≥80岁4个年龄组前列腺癌的检出率分别为11．1％、23．6％、40．0％、46.7％,随着年龄的增长,前列腺癌的检出率增长明显（P ＝0．011）。前列腺穿刺患者前列腺癌检出率与血清 PSA值呈正相关（r ＝0．376,P ＜0．001）,前列腺癌检出率与年龄亦呈正相关（r ＝0．288,P ＝0．019）。结论：随着年龄的增加、血清 PSA 值增高,前列腺穿刺患者前列腺癌的检出率也相应增高。     

穿刺活检前列腺癌53例分析

目的：探讨穿刺活检病理诊断前列腺癌的形态学特征。方法：对138例前列腺穿刺活检标本包括53例前列腺癌进行回顾性分析。78例做了免疫组织化学检查。结果：根据结构紊乱、细胞学异型性和浸润等病理形态，确诊53例前列腺癌，其中高分化腺癌10例(18．9％)，中分化腺癌16例(30．2％)，低分化腺癌27例(50．9％)。结论：前列腺穿刺活检是诊断前列腺癌的有效方法。主要根据病理形态学特征．结合临床及免疫组化结果,才能作出正确的诊断。     

超声形态学及血流测定诊断前列腺癌的初探

目的：探讨超声诊断前列腺癌的新途径。方法：应用超声检测前列腺的形态学参数及血流参数。结果：前列腺癌组的ｈ％、ｖ明显高于前列腺增生组或正常组（Ｐ〈０．０５），ＰＩ则低于其余二组（Ｐ〈０．０５），结论：（１）外腺连续性中断；（２）ｈ％〉４５％；（３）ｖ〉３．０ｃｍ＾３，（４）ＰＩ〈１．５０符合上述条件２项或２项以上者诊断前列腺癌符合率９２．６％、敏感性８５．２％，特异性９７．３％。     

经尿道前列腺电切术72例前列腺疾病应用分析

[目的]评价经尿道前列腺电切术（TURP）在检测前列腺癌中的作用。[方法]回顾性分析72例高度怀疑前列腺癌而活检阴性的患者行TURP术的临床资料。[结果]72例患者中病理诊断前列腺癌15例（占20.8%）。病理结果良性的患者,2例患者术后复查PSA异常,再次穿刺活检确诊前列腺癌。[结论]TURP术既是前列腺增生的治疗手段,也是一种前列腺癌的检测方法。     

经直肠彩超引导下穿刺诊断前列腺癌的临床分析

目的评估经直肠彩超引导下前列腺穿刺活检术在前列腺癌诊断和鉴别诊断中的价值。方法对直肠指检阳性或经直肠彩超检查怀疑有占位性病变的35例患者行经直肠彩超引导下前列腺穿刺活检。结果经直肠彩超引导下穿刺诊断前列腺癌的敏感度、特异度分别为84．2％、81．5％,与手术切检比较差异无统计学意义;前列腺癌病灶RI≥0．75者所占比例显著高于非前列腺癌结节者（P〈0．05）。结论经直肠彩超引导下前列腺穿刺活检操作简单、安全,对前列腺癌的诊断具有重要的指导意义。     

改良13点前列腺穿刺活检在前列腺癌诊断中的应用

目的 评价经直肠超声引导改良13点前列腺穿刺活检对诊断前列腺癌的临床价值.方法 对2015年10月至2016年10月在陕西省人民医院就诊的82例临床疑似前列腺癌患者的临床资料进行回顾性分析.所有患者均进行了经直肠超声引导改良13点前列腺穿刺活检及手术治疗,将穿刺病理结果与术后病理结果进行比较,并比较改良13点穿刺法和标准6点穿刺法诊断前列腺癌的准确性,分析改良13点前列腺穿刺活检术的并发症.结果 82例疑似前列腺癌患者中,26例经直肠超声引导下改良13点前列腺穿刺术诊断为前列腺癌,54例诊断为前列腺增生,此80例诊断结果与术后病理相符,另2例穿刺活检诊断为前列腺增生而术后病理证实为前列腺癌.改良13点穿刺法和标准6点穿刺法诊断前列腺癌的准确性分别为97.6％（80/82）和84.1％（69/82）,两者比较差异有统计学意义（P=0.023）.所有接受改良13点法前列腺穿刺活检术的患者无一例出现严重的并发症.结论 经直肠超声引导改良13点前列腺穿刺活检术是一种安全、有效的前列腺系统穿刺活检术式,值得在临床推广应用.     

超声引导下经直肠前列腺穿刺活检560例分析

目的：探讨15针经直肠超声引导下前列腺穿刺活检术诊断前列腺癌的临床价值及其安全性。方法：回顾性分析我院2010-01—10—2012—12—20560例初次行经直肠超声引导下前列腺穿刺活检术的可疑前列腺癌患者的临床资料,对穿刺结果及穿刺后并发症情况做相关分析。结果：560例穿刺患者平均年龄（67．34±9．75）岁,平均前列腺特异性抗原（prostatespecificantigen,PSA）水平为（8．41±33．45）μg／L,平均前列腺体积大小为（64．52±35．47）mL,穿刺结果为前列腺癌214例（38．2％）,前列腺增生65例（11．6％）,前列腺增生伴低级别上皮内瘤变（prostaticintraepithelialneoplasia,PIN）I128例（22．9％）,PINII～Ⅲ35例（6．3％）,良性前列腺增生（benignprostatichyperplasia,BPH）伴慢性炎症96例（17．1％）,腺泡状横纹肉瘤1例。穿刺术后119例出现肉眼血尿（21．3％）,尿频、尿急和尿痛18例（3．2％）,直肠出血3例（0．5％）,急性尿潴留15例（2．7％）,发热10例（1．8％）,无其他严重并发症。结论：经直肠超声引导下前列腺15针系统穿刺法穿刺阳性率高,并发症少,是诊断前列腺癌的安全、有效方法,值得推广。     

Gleason histologic grading of prostatic carcinoma. Correlations between biopsy and prostatectomy specimens

The Gleason histologic score of prostatic adenocarcinoma in biopsy specimens (needle cores or transurethral chips) was compared with the Gleason score of corresponding radical prostatectomy specimens from 53 patients with localized prostatic carcinoma. The Gleason score assigned to the biopsy specimen was identical to that of the prostatectomy specimen in 51% of cases, was greater than that of the prostatectomy specimen in 4%, and was less than that of the prostatectomy specimen in 45%. The magnitude of discrepancy between the scores of the biopsy specimen and the prostatectomy specimen was directly related to the quantity of neoplastic tissue in the biopsy specimen. Discrepancies between the Gleason score of biopsy material and prostatectomy specimens were greater among biopsy specimens with low Gleason scores as compared with biopsy specimens with high Gleason scores. Given the small number of cases, these differences were not statistically significant. Clinical understaging of the primary tumor did not correlate with histologic undergrading of the prostatectomy specimen. It was concluded that prostatic biopsy should be repeated when the initial diagnosis of adenocarcinoma is based on only limited quantities of neoplastic tissue with a low Gleason score and management decisions may be influenced by the true Gleason score of the tumor.     

Fine needle aspiration biopsy in clinical management of head and neck tumors

Ninety-five percent (195) of 203 fine needle aspiration biopsies (FNAB) of head and neck specimens contained adequate tissues for histologic evaluation. No complications or needle tract recurrences were identified. Out of 135 patients whose surgical excision followed FNAB, 5% (7/135) of the biopsies were nondiagnostic. Correlation of cytologic and histologic findings of the remaining 128 FNAB revealed a sensitivity rate of 82% (46/56), a specificity rate of 99% (71/72), and a positive predictive of value of 98% (46/47). The diagnostic accuracy of FNAB was better with salivary gland and cervical node specimens than with thyroid, skin, and subcutaneous specimens. Fine needle aspiration biopsy may be considered as the first diagnostic step in the evaluation of the mass of the head and neck region, if the nondiagnostic aspiration rate is low and the diagnostic accuracy is high.     

Rapid detection of metastatic melanoma in lymph nodes using proton magnetic resonance spectroscopy of fine needle aspiration biopsy specimens

Accurate staging of patients with primary cutaneous melanoma includes assessment of regional lymph nodes for the presence of micrometastatic disease. Sentinel lymph node biopsy is highly accurate but is an invasive surgical procedure with a 5-10% complication rate, and requires labour-intensive and expensive histological examination to identify disease. A rapid, accurate and cost-effective non-surgical technique able to detect micrometastatic deposits of melanoma in regional lymph nodes would be of great benefit. Fine needle aspiration biopsies and tissue specimens were obtained from lymph nodes from 18 patients undergoing node resection for metastatic melanoma and five patients undergoing radical retropubic prostatectomy. One-dimensional proton magnetic resonance spectroscopy was undertaken at 360 MHz (8.5 T). Lymph nodes were cut into 3 mm thick slices and embedded. Four sequential 5 microm tissue sections were cut from each block and stained, with haematoxylin and eosin, for S100 protein, for HMB45, and again with haematoxylin and eosin, respectively. Proton magnetic resonance spectroscopy distinguished between benign and malignant lymph node tissue (P < 0.001, separate t-test) and benign and malignant lymph node fine needle aspiration biopsy (P < 0.012) based on the ratio of the integrals of resonances from lipid/other metabolites (1.8-2.5 p.p.m. region) and 'choline' (3.1-3.3 p.p.m. region). In conclusion, one-dimensional proton magnetic resonance spectroscopy on a simple fine needle aspiration biopsy can distinguish lymph nodes containing metastatic melanoma from uninvolved nodes, providing a rapid, accurate and cost-effective non-surgical technique to assess regional lymph nodes in patients with melanoma.     

细针穿刺肿瘤组织端粒酶活性检测在乳腺癌诊断中的意义

目的 :探讨细针穿刺乳腺肿瘤组织端粒酶活性检测在乳腺癌诊断中的意义。方法 :用PCR ELISA法检测79例术前乳腺肿瘤穿刺活检标本和大体标本的端粒酶活性并与病理诊断进行对照。结果 :乳腺癌 65例 ,穿刺组织端粒酶阳性 5 7例 ,阳性率为 87 7% ;大体组织端粒酶阳性 5 4例 ,阳性率83 1% ;淋巴结有转移者端粒酶活性高于无淋巴结转移者 ;乳腺良性疾病 14例 ,端粒酶阳性 2例 ,阳性率 14 3 %。结论 :术前乳腺肿瘤穿刺组织端粒酶活性检测有利于乳腺肿瘤的早期诊断及鉴别诊断 ,可以间接了解乳腺癌的进展程度     

不同活检方式对淋巴瘤诊断价值的研究进展

淋巴瘤是我国常见的恶性肿瘤之一,病理学检查是诊断淋巴瘤的主要手段。足量、合格的组织标本是对淋巴瘤进行形态观察以及开展免疫表型和遗传学研究的物质基础。由于活检设备及图像引导设备的发展与进步,目前除手术切除活检外粗针穿刺活检及细针穿刺活检也逐渐成为临床医生诊断淋巴瘤的选择之一。本文就不同活检方式对淋巴瘤的诊断价值进行一个简要的归纳总结。     

超声引导下甲状腺结节细针穿刺细胞学与粗针穿刺组织学检查的对比研究CSCD

目的比较超声引导下甲状腺结节细针穿刺细胞学与粗针穿刺组织学检查的诊断准确率、敏感度、特异性及并发症。方法收集95例超声检查疑似为恶性甲状腺结节患者的98个结节,行超声引导下细针穿刺细胞学与粗针穿刺组织学检查,并经术后常规病理检查证实。比较两种方法诊断甲状腺结节的准确率、敏感度、特异性及术后并发症。分析结节直径大小与取材满意率、诊断准确率的关系。结果 (1)细针穿刺取材满意率89.8%,粗针为96.9%。细针穿刺细胞学诊断甲状腺结节的准确率、敏感度、特异性分别为86.4%、90.5%、82.6%;粗针穿刺组织学诊断为90.5%、91.7%、88.6%;(2)粗针穿刺并发症发生率高于细针穿刺(14.3% vs.2.0%,P<0.05);(3)结节直径≥1.0 cm时,粗针穿刺诊断准确率高于细针穿刺(P<0.05)。结论细针穿刺细胞学与粗针穿刺组织学检查在甲状腺结节良恶性诊断中可互相补充。     

Immunohistochemical analysis of estrogen receptors in cells obtained by fine needle aspiration from human mammary carcinomas

An immunocytochemical assay for the estrogen receptor has been used to analyze the receptor content in tumor cells obtained by fine needle aspiration from human breast carcinomas. The results were compared with receptor determinations on cryostat sections of freshly frozen tumors and by biochemical technique based on radiolabelled ligand binding. The staining intensity and fraction of positive cells were comparable in cryostat sections and tumor cell specimens obtained by fine needle aspiration. Moreover, there was a good correlation between the semiquantitative receptor level estimated by the immunoperoxidase technique and the biochemical assay. These results show that tumor cell specimens obtained by fine needle aspirates can be used for estrogen receptor analysis by the immunocytochemical technique.     

Tru-Cut穿刺活检联合细针针吸活检在胰腺癌术中病理诊断中的应用

目的 探讨Tru-Cut穿刺活检(TCB)联合细针针吸活检(FNA)在胰腺癌术中病理诊断中的应用价值.方法 对22例术前诊断为胰腺癌的患者,术中进行肿物的TCB联合FNA,进行前瞻性研究.结果 22例患者中,TCB联合FNA诊断胰腺癌19例,3例既未见癌组织,亦未发现癌细胞.其中1例术中肝结节活检证实为肝转移,结合临床考虑胰腺癌肝转移;1例诊为自身免疫性胰腺炎;1例随访9个月,肿物无变化,诊为慢性胰腺炎.TCB诊断准确率为90.9%,FNA诊断准确率为86.4%,TCB联合FNA诊断准确率为95.5%.术后无胰瘘、出血等并发症发生.结论 TCB联合FNA的方法提高了胰腺癌术中诊断的准确率,是一种安全有效的诊断方法.     

针吸细胞病理学在临床应用中的价值探讨

目的：探讨针吸细胞学在临床应用中的价值。方法：采用细针吸取细胞分析３６１９０人次诊断结果。结果：３６１９０人次针吸细胞学阳性检出率为８９．５％,７９１例细胞学诊断为肿瘤或瘤样增生者与病理对照,诊断符合率为８７．６％;２０６４例细胞学府晨瘤性疾病或病变者,被临床和病理证实为恶性肿瘤者２５例,生肿瘤１５６例,假队性率为８．８％。结论：针吸细胞学诊断的敏感性和特异性尚满意,具实用价值,但其准确性低于病理     

Use of monoclonal antibodies in immunocytochemical localization of estrogen receptors in ovarian cancer

Ovarian cancer specimens from 45 patients were assayed for the presence of estrogen receptor (ER) utilizing highly specific monoclonal antiestrophilin antibodies and the peroxidase-antiperoxidase technique. Results were compared with the conventional ER determination of the dextran charcoal method (DCC) and were in concordance in 91% of cases. This technique was also used to analyze ER in fine needle aspiration biopsy specimen from four patients with metastatic ovarian tumor. These results suggest that antireceptor monoclonal antibody in immunohistochemical analysis is an effective tool in the evaluation of estrogen receptor content in ovarian cancer. This technique can be easily performed at community hospitals and may be extended to the evaluation of fine needle aspiration biopsies and to analyze specimens of insufficient size for biochemical assay.