Souza Frederico F, Mortelé Koenraad J, Cibas Edmund S, Erturk Sukru M, Silverman Stuart G
Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115, USA.
AJR Am J Roentgenol. 2009 Jan;192(1):131-6. doi: 10.2214/AJR.08.1283.
The objective of our study was to determine the predictive value of percutaneous imaging-guided biopsy of peritoneal and omental masses.
A retrospective study of 111 patients who underwent biopsy of a peritoneal or omental mass from 1998 to 2006 was performed. Biopsy results were classified as diagnostic (malignant or benign) or nondiagnostic. Sensitivity, specificity, and negative predictive value (NPV) were calculated for all patients, and the Fisher-Freeman-Halton exact test was used to determine whether test characteristics varied by patient history (presence of a known cancer), mass size (<4 cm vs >or= 4 cm), and needle size (biopsies with fine needles vs biopsies with fine and large needles).
The overall diagnostic rate was 89% (99/111); there were 86 true-positive, one false-positive, six true-negative, and six false-negative results (sensitivity, 93% [86/92]; specificity, 86% [6/7]; NPV, 50% [6/12]). There were no statistically significant differences between patients with and without known cancer. Among 79 patients with known cancer, 52 (66%) had metastatic disease from the known cancer; in eight (10%) patients, the biopsy result yielded new primary cancers. Of 32 patients with no known cancer, 23 (72%) had malignant results. Biopsy test characteristics did not differ with respect to mass or needle size. Minor complications were seen in three (3%) patients.
Percutaneous imaging-guided biopsy of peritoneal and omental masses is a safe, effective procedure that is useful in clinical practice. A second malignancy was revealed in a substantial number of patients with a known primary cancer. A new malignancy was diagnosed in most patients without a history of cancer.
本研究的目的是确定经皮影像引导下对腹膜和网膜肿块进行活检的预测价值。
对1998年至2006年期间接受腹膜或网膜肿块活检的111例患者进行回顾性研究。将活检结果分为诊断性（恶性或良性）或非诊断性。计算所有患者的敏感性、特异性和阴性预测值（NPV），并使用Fisher-Freeman-Halton精确检验来确定检测特征是否因患者病史（已知癌症的存在）、肿块大小（<4 cm与≥4 cm）和针的大小（细针活检与细针和粗针活检）而有所不同。
总体诊断率为89%（九十九/一百一十一）；有86例假阳性、1例假阴性、6例假阴性和6例假阴性结果（敏感性，93%[八十六/九十二]；特异性，86%[六/七]；NPV，50%[六/十二]）。有已知癌症和无已知癌症的患者之间无统计学显著差异。在79例已知癌症的患者中，52例（66%）患有已知癌症的转移性疾病；在8例（10%）患者中，活检结果显示为新发原发性癌症。在32例无已知癌症的患者中，23例（72%）结果为恶性。活检检测特征在肿块或针的大小方面没有差异。3例（3%）患者出现轻微并发症。
经皮影像引导下对腹膜和网膜肿块进行活检是一种安全、有效的方法，在临床实践中很有用。在大量已知原发性癌症的患者中发现了第二种恶性肿瘤。在大多数无癌症病史的患者中诊断出了新的恶性肿瘤。
