Bedenne L, Mottot C, Courtois B, Meny B, Cauvin J M, Hillon P, Michiels R, Klepping C
Service d'Hépato-Gastroentérologie, Hôpital Général, Dijon.
Gastroenterol Clin Biol. 1990;14(1):62-6.
A comparison of diagnostic efficiency of fine needle biopsy (22 G) versus coarse needle biopsy (Tru-Cut 14 G) was performed on ultrasound-guided liver biopsies in 45 patients. Diagnosis was established through clinical, paraclinical and pathologic features. For each patient pathologic examination of both fine needle biopsy (cytology and histology) and coarse needle biopsy (histology) were performed by a pathologist unaware of any clinical data. Of 36 malignant tumors, diagnosis of malignancy was made in 83 percent of the cases by fine needle biopsy and in 81 percent of the cases by Tru-Cut biopsy, and distinction between primary and secondary cancer, in 83 and 86 percent of cases respectively. Specificity was 100 percent with both techniques. Of 9 benign lesions, the 6 focalized fatty infiltrations were diagnosed by both fine and coarse needle biopsies. As fine needle biopsy is less invasive than coarse needle biopsy and gave equally satisfying results, we suggest that it should be used preferentially in the diagnosis of focalized liver lesions.
对45例患者进行超声引导下肝脏活检,比较了细针穿刺活检(22G)与粗针穿刺活检(Tru-Cut 14G)的诊断效率。通过临床、辅助检查和病理特征来确立诊断。对于每位患者,由不了解任何临床数据的病理学家对细针穿刺活检(细胞学和组织学)和粗针穿刺活检(组织学)进行病理检查。在36例恶性肿瘤中,细针穿刺活检诊断恶性肿瘤的病例占83%,Tru-Cut活检诊断恶性肿瘤的病例占81%,区分原发性和继发性癌症的病例分别占83%和86%。两种技术的特异性均为100%。在9例良性病变中,6例局灶性脂肪浸润通过细针和粗针活检均得以诊断。由于细针穿刺活检的侵入性小于粗针穿刺活检且结果同样令人满意,我们建议在局灶性肝脏病变的诊断中应优先使用细针穿刺活检。