Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital AG, Aarau, Switzerland.
Head Neck. 2012 Oct;34(10):1497-503. doi: 10.1002/hed.21821. Epub 2011 Aug 24.
Core-needle biopsy (CNB) has occasionally been used in the work-up of head and neck lesions. However, no systematic review of this simple, minimally invasive method has yet been performed.
A systematic review of the literature and meta-analysis of data extracted from 16 included studies were performed. A total of 1291 cervical lesions in 1267 patients were examined by CNB. This resulted in 1232 adequate samples, from which 554 were subsequently confirmed by excisional biopsy.
CNB was able to identify true neoplasms and detect malignancy in head and neck lesions with an overall accuracy of 94% and 96%, respectively, even though there was a significant difference between the histologically verified and all adequate samples. CNB provided a correct specific diagnosis in 87% of cases without major complications and achieved a higher accuracy than that of fine-needle aspiration in detecting malignancy.
This meta-analysis confirms that CNB is an excellent method in the assessment of salivary gland lesions and lymphadenopathies inclusive of malignant lymphoma, but it is not ideal for evaluating thyroid lesions.
在头颈部病变的检查中,偶尔会使用核心针活检(CNB)。然而,目前尚未对头颈部病变进行过这种简单、微创方法的系统评价。
对 16 项纳入研究的文献进行系统回顾和荟萃分析,从其中提取数据。共对 1267 例患者的 1291 个颈部病变进行了 CNB 检查,获得了 1232 个充足的样本,其中 554 个随后通过切除术活检得到证实。
即使在组织学验证与所有充足样本之间存在显著差异的情况下,CNB 仍能够对头颈部病变中的真正肿瘤和恶性肿瘤进行识别,总体准确率分别为 94%和 96%。CNB 在没有主要并发症的情况下正确诊断出 87%的病例,在检测恶性肿瘤方面的准确率高于细针抽吸活检。
这项荟萃分析证实,CNB 是评估唾液腺病变和包括恶性淋巴瘤在内的淋巴结病的极佳方法,但对于评估甲状腺病变并不理想。