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[经皮细胞学穿刺在胰腺肿瘤术前评估中的价值与风险]

[Value and risks of percutaneous cytological puncture in the preoperative assessment of pancreas tumors].

作者信息

Elsman B H, de Graaf P W, van Leeuwen M S, Obertop H

机构信息

Afd. Chirurgie, Academisch Ziekenhuis, Utrecht.

出版信息

Ned Tijdschr Geneeskd. 1992 Jul 25;136(30):1459-62.

PMID:1436162
Abstract

In a period of a little over two years 34 preoperative fine needle aspiration biopsies were performed in 32 patients with a possible malignant lesion of the pancreas. A cytological diagnosis of cancer was obtained in 22 patients. On follow-up 27 patients, in whom 28 biopsies were performed, proved to have a malignant tumour. The overall sensitivity of fine needle aspiration cytology in diagnosing a malignancy was 77.8%. There were no false positive results (specificity: 100%). Three patients developed serious biopsy-related complications. This relatively low sensitivity and the fact that a biopsy is not without risk leads to the advice not to perform preoperative fine needle aspiration biopsies as a routine in patients in whom curative or palliative surgery is indicated. Percutaneous biopsy is advised and can be useful if no indication for surgery is present because of the patient's condition or the extent of the disease and non-surgical palliation is the treatment of choice.

摘要

在两年多一点的时间里,对32例可能患有胰腺恶性病变的患者进行了34次术前细针穿刺活检。22例患者获得了癌症的细胞学诊断。在随访的27例患者中(共进行了28次活检),证实患有恶性肿瘤。细针穿刺细胞学诊断恶性肿瘤的总体敏感性为77.8%。没有假阳性结果(特异性:100%)。3例患者出现了严重的活检相关并发症。这种相对较低的敏感性以及活检并非没有风险这一事实,导致建议不要对有根治性或姑息性手术指征的患者常规进行术前细针穿刺活检。建议进行经皮活检,如果由于患者病情或疾病范围而不存在手术指征且非手术姑息治疗是首选治疗方法,那么经皮活检可能会有用。

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