超声引导下粗针活检与细针穿刺在头颈部病变评估中的比较。
Comparison of ultrasound-guided core-needle biopsy and fine-needle aspiration in the assessment of head and neck lesions.
作者信息
Kraft Marcel, Laeng Hubert, Schmuziger Nicolas, Arnoux André, Gürtler Nicolas
机构信息
Department of Otorhinolaryngology-Head and Neck Surgery, Kantonsspital Aarau, Aarau, Switzerland.
出版信息
Head Neck. 2008 Nov;30(11):1457-63. doi: 10.1002/hed.20891.
BACKGROUND
Core-needle biopsy (CNB) has been successfully applied in other medical specialties, but its value is undetermined in otolaryngology.
METHODS
This prospective study includes 75 patients, who were seen at our institution with a cervical mass. The results of CNB were compared with those of fine-needle aspiration (FNA) in the 68 histologically verified cases.
RESULTS
CNB was superior to FNA providing a specific diagnosis (90% vs 66%) and achieved a higher accuracy in identifying true neoplasms (100% vs 93%) and detecting malignancy (99% vs 90%). However, the sensitivity and specificity did not differ significantly between both methods.
CONCLUSIONS
Sonography and if necessary FNA should continue to be the investigation method of first choice for head and neck lesions. The main indication for CNB is after repeated failures of FNA to provide a diagnosis. It can also be performed in patients who are not surgical candidates or in those who refuse surgery.
背景
粗针活检（CNB）已成功应用于其他医学专科，但其在耳鼻喉科的价值尚未确定。
方法
这项前瞻性研究纳入了75例在我院就诊的颈部肿块患者。在68例经组织学证实的病例中，将CNB的结果与细针穿刺抽吸（FNA）的结果进行了比较。
结果
CNB在提供明确诊断方面优于FNA（90%对66%），在识别真性肿瘤（100%对93%）和检测恶性肿瘤（99%对90%）方面具有更高的准确性。然而，两种方法之间的敏感性和特异性没有显著差异。
结论
超声检查以及必要时的FNA应继续作为头颈部病变的首选检查方法。CNB的主要适应证是FNA反复未能提供诊断。它也可以在不适合手术的患者或拒绝手术的患者中进行。
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