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细针穿刺细胞学检查在可手术乳腺癌的新辅助化疗中可发挥作用。

Fine-needle aspiration cytology can play a role in neoadjuvant chemotherapy in operable breast cancer.

作者信息

Garbar Christian, Curé Hervé

机构信息

Departments of Biopathology and Medical Oncology, Institut Jean-Godinot-Unicancer, 51726 Reims Cedex, France.

出版信息

ISRN Oncol. 2013 Jul 10;2013:935796. doi: 10.1155/2013/935796. Print 2013.

Abstract

Despite the fact that CNB has been progressively replaced by FNAC in the investigation of nonpalpable lesions or microcalcifications without a clinical or radiological mass lesion, FNAC has yet a role in palpable lesions provided it is associated with the triple diagnosis and experienced cytologist. In these conditions, FNAC is a safe, effective, economical, and accurate technique for breast cancer evaluation. Numerous literature reviews and meta-analyses illustrated the advantages and disadvantages of both methods CNB and FNAC. The difference does not seem significant when noninformative and unsatisfactory FNAC was excluded. Recently, cytological methods using liquid-based cytology (LBC) technology improve immunocytological and molecular tests with the same efficiency as classical immunohistochemistry. The indications of FNAC were, for palpable lesions, relative contraindication of CNB (elderly or frailty), staging of multiple nodules in conjunction or not with CNB, staging of lymph node status, newly appearing lesion in patient under neoadjuvant treatment, decreasing of anxiety with a rapid diagnosis, evaluation of biomarkers and new biomarkers, and chronological evaluation of biomarker following the neoadjuvant therapy response.

摘要

尽管在对不可触及的病变或无临床或放射学肿块病变的微钙化进行检查时,粗针活检(CNB)已逐渐被细针穿刺抽吸活检(FNAC)所取代,但在可触及的病变中,若与三联诊断及经验丰富的细胞病理学家相结合,FNAC仍有其作用。在这些情况下,FNAC是一种用于乳腺癌评估的安全、有效、经济且准确的技术。众多文献综述和荟萃分析阐述了CNB和FNAC这两种方法的优缺点。当排除无诊断价值和不满意的FNAC结果时,两者差异似乎并不显著。近来,采用液基细胞学(LBC)技术的细胞学方法,能以与经典免疫组织化学相同的效率改进免疫细胞学和分子检测。对于可触及的病变,FNAC的适应证包括CNB的相对禁忌证(老年或体弱)、联合或不联合CNB对多个结节进行分期、评估淋巴结状态、新辅助治疗患者出现的新病变、通过快速诊断减轻焦虑、评估生物标志物和新的生物标志物,以及在新辅助治疗反应后对生物标志物进行时序评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba42/3725715/b7cfb332405f/ISRN.ONCOLOGY2013-935796.001.jpg

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