Schadt M E, Kline T S, Neal H S, Scoma R S, Naryshkin S
Department of Surgery Lankenau Hospital, Philadelphia, Pennsylvania.
Am Surg. 1991 Feb;57(2):73-5.
Intraoperative fine needle aspiration biopsy (NAB) of undiagnosed pancreatic masses was studied in 166 patients over a 17-year period. The cytologic diagnoses were correlated with histologic specimens, autopsy results, or clinical follow-up (benign disease was documented if the patient was alive without malignancy at least 2 years after laparotomy). Aspirates were interpreted as benign, suspicious, malignant, or unsatisfactory. Malignant disease was the final diagnosis in 109 patients; the cytology was concordant in 101 and was interpreted as suspicious in four. Four patients with benign cytology later proved to have malignant disease--a false-negative rate of 2.5 per cent. A total of 57 patients had benign disease; 51 of these had benign cytology. The remaining patients had "unsatisfactory" cytology reports. A 93 per cent sensitivity, 100 per cent specificity, and 0 per cent complication rate are reported. There were no false-positive cytology reports. Complications are rare and represent case reports, thus, additional sampling is at minimal risk. Intraoperative pancreatic NAB is a safe, easy, more accurate biopsy technique than historical wedge or core needle biopsies. It is the biopsy method of choice for pancreatic masses found at laparotomy.
在17年的时间里，对166例患者术中未确诊的胰腺肿块进行了细针穿刺活检（NAB）。将细胞学诊断结果与组织学标本、尸检结果或临床随访情况进行了对比（如果患者在剖腹手术后至少存活2年且无恶性肿瘤，则记录为良性疾病）。穿刺物被解读为良性、可疑、恶性或不满意。109例患者最终诊断为恶性疾病；其中101例的细胞学诊断与之相符，4例被解读为可疑。4例细胞学诊断为良性的患者后来被证实患有恶性疾病，假阴性率为2.5%。共有57例患者患有良性疾病；其中51例的细胞学诊断为良性。其余患者的细胞学报告为“不满意”。据报告，该检查的敏感性为93%，特异性为100%，并发症发生率为0%。没有假阳性的细胞学报告。并发症罕见，仅为个案报道，因此，额外取样的风险极小。术中胰腺NAB是一种比传统楔形或粗针活检更安全、简便且更准确的活检技术。它是剖腹手术中发现的胰腺肿块的首选活检方法。
