Tamura Ryo, Kashima Katsunori, Asatani Mina, Nishino Koji, Nishikawa Nobumichi, Sekine Masayuki, Serikawa Takehiro, Enomoto Takayuki
Departments of *Obstetrics and Gynecology, and †Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Int J Gynecol Cancer. 2014 Jul;24(6):1042-7. doi: 10.1097/IGC.0000000000000189.
The differential diagnosis between uterine sarcoma and benign leiomyoma is difficult when made only by magnetic resonance imaging (MRI); it usually requires an additional preoperative diagnostic procedure. We report our results using ultrasound-guided needle biopsy for these types of uterine tumors.
Ultrasound-guided needle biopsy was performed on 63 patients with uterine smooth muscle tumors suspected of malignancy by MRI. We compared the results of presurgical biopsy against the postsurgical pathology of the tumor.
Among 63 patients with a high signal intensity of the uterine tumor on T2-weighted MRI (1 case was undetermined), 12 cases (19.3%) were diagnosed by the needle biopsy as malignant, and 51 cases (80.6%) were benign. Among the 12 diagnosed as malignant tumors, 11 had surgery performed, and one was treated with chemotherapy. Among the 51 patients diagnosed with a benign tumor, 27 had surgery performed, and 24 were put on a wait-and-see clinical follow-up schedule. One of the 27 surgical patients with a benign tumor had a postsurgical diagnosis of a low-grade endometrial stromal sarcoma. In the 38 cases where surgery was performed, we found the sensitivity, specificity, and the positive and negative predictive values of the needle biopsy were 91.7%, 100%, 100%, and 96.2%, respectively.
Ultrasound-guided needle biopsy may be a reliable preoperative diagnostic procedure for uterine tumors with suspected malignancy.
仅通过磁共振成像（MRI）来鉴别子宫肉瘤和良性平滑肌瘤存在困难；通常需要额外的术前诊断程序。我们报告了使用超声引导下针吸活检诊断这类子宫肿瘤的结果。
对63例经MRI怀疑为恶性的子宫平滑肌肿瘤患者进行了超声引导下针吸活检。我们将术前活检结果与肿瘤的术后病理结果进行了比较。
在63例T2加权MRI上子宫肿瘤呈高信号强度的患者中（1例结果未确定），针吸活检诊断为恶性的有12例（19.3%），良性的有51例（80.6%）。在诊断为恶性肿瘤的12例患者中，11例接受了手术，1例接受了化疗。在诊断为良性肿瘤的51例患者中，27例接受了手术，24例进行临床观察随访。27例手术的良性肿瘤患者中有1例术后诊断为低级别子宫内膜间质肉瘤。在38例接受手术的患者中，我们发现针吸活检的敏感性、特异性、阳性预测值和阴性预测值分别为91.7%、100%、100%和96.2%。
超声引导下针吸活检可能是一种用于怀疑为恶性的子宫肿瘤的可靠术前诊断程序。
