Gong Yun, Sneige Nour, Guo Ming, Hicks Marshall E, Moran Cesar A
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston 77030, USA.
Am J Clin Pathol. 2006 Mar;125(3):438-44.
To assess the value and limitations of fine-needle aspiration (FNA) and core needle biopsy (CNB) in the diagnosis of intrathoracic lesions, we retrospectively compared the diagnostic accuracy of 362 FNA and concurrent CNB procedures performed on 350 patients. Based on the final diagnoses that were determined based on combined information from biopsy, resection, clinical, radiologic, and microbiologic findings, the study cases were grouped into 188 malignant, 161 benign, and 13 inconclusive lesions. FNA and CNB yielded similar diagnostic accuracy for malignant tumors (85.1% vs 86.7%) and epithelial malignant neoplasms (86.4% vs 85.2%), whereas CNB yielded better diagnostic accuracy (96%) than FNA (77%) for nonepithelial malignant neoplasms. Combined FNA and CNB substantially improved the rate of malignancy diagnosis (95.2%). Of 161 benign cases, 50 were proven to be benign-specific lesions; FNA provided specific diagnosis in 20 (40%) and CNB in 46 (92%). The remaining 111 benign lesions yielded benign-nonspecific findings on both specimens. These results indicate that CNB should be obtained when clinical or radiologic findings do not match the cytologic findings or nonepithelial lesions and benign lesions are considered likely.
为评估细针穿刺抽吸活检（FNA）和粗针穿刺活检（CNB）在诊断胸内病变中的价值和局限性，我们回顾性比较了对350例患者进行的362次FNA及同期CNB操作的诊断准确性。根据活检、切除、临床、放射学及微生物学检查结果综合信息确定的最终诊断，将研究病例分为188例恶性病变、161例良性病变和13例诊断不明确的病变。FNA和CNB对恶性肿瘤（85.1%对86.7%）及上皮性恶性肿瘤（86.4%对85.2%）的诊断准确性相似，而对于非上皮性恶性肿瘤，CNB的诊断准确性（96%）高于FNA（77%）。FNA与CNB联合使用显著提高了恶性病变的诊断率（95.2%）。在161例良性病例中，50例被证实为良性特异性病变；FNA对其中20例（40%）做出了特异性诊断，CNB对46例（92%）做出了特异性诊断。其余111例良性病变在两种标本上均显示为良性非特异性结果。这些结果表明，当临床或放射学检查结果与细胞学检查结果不符，或考虑可能为非上皮性病变及良性病变时，应进行CNB检查。
