Szlęzak Przemysław, Srutek Ewa, Gorycki Tomasz, Kowalewski Janusz, Studniarek Michał
Department of Diagnostic Imaging and Interventional Radiology, Franciszek Łukaszczyk Oncology Center, Bydgoszcz, Poland.
Department of Tumor Pathology and Pathomorphology, Franciszek Łukaszczyk Oncology Center, Bydgoszcz, Poland.
Pol J Radiol. 2014 Jul 1;79:175-80. doi: 10.12659/PJR.889948. eCollection 2014.
Patients with pathological tissue mass in thoracic cage found with imaging require histopathological or cytological confirmation of malignancy before treatment. The tissue material essential for patomorphological evaluation can be acquired with fine-needle aspiration biopsies (FNAB) controlled with CT and core-needle biopsy (CNB) under real-time CT fluoroscopy guidance. The purpose of this work is to carry out a retrospective analysis of the two methods with regards to their informativity, frequency and the kind of complications.
MATERIAL/METHODS: From January, 2012 to May 2013, 76 core-needle biopsies of lung and mediastinum tumors were conducted and compared with 86 fine-needle aspiration biopsies(FNAB) of lung and mediastinum tumors, including 30 patients who underwent FNAB and were referred to CNB in order to specify the diagnosis.
Complete histopathological diagnosis was made in 91% with the use of CNB and in 37% when FNAB was the chosen method. Early complications were observed in 32% patients who underwent BG and in group of 11% who underwent FNAB. Late complications, however, appeared in 29% patients after CNB and 13% after FNAB. In 24 cases CNB specified the complete diagnosis.
Core-needle biopsy in comparison to fine-needle aspiration biopsy has more frequent rate of negligible complications, however, it offers higher diagnostic yield for diagnostic of lung and mediastinum neoplastic disease and allows for more precise diagnosis of focal lesions.
影像学检查发现胸廓有病理组织肿块的患者，在治疗前需要进行组织病理学或细胞学检查以确诊恶性肿瘤。通过CT引导下的细针穿刺活检（FNAB）以及实时CT透视引导下的粗针活检（CNB），可以获取病理形态学评估所需的组织材料。本研究旨在对这两种方法的信息量、频率及并发症类型进行回顾性分析。
材料/方法：2012年1月至2013年5月，对76例肺及纵隔肿瘤进行粗针活检，并与86例肺及纵隔肿瘤细针穿刺活检（FNAB）进行比较，其中30例患者先进行了FNAB，之后又接受了CNB以明确诊断。
使用CNB时，91%的患者获得了完整的组织病理学诊断；而采用FNAB时，这一比例为37%。接受CNB的患者中32%出现早期并发症，接受FNAB的患者中这一比例为11%。然而，CNB后29%的患者出现晚期并发症，FNAB后这一比例为13%。24例患者通过CNB明确了完整诊断。
与细针穿刺活检相比，粗针活检的轻微并发症发生率更高，但对于肺及纵隔肿瘤疾病的诊断具有更高的诊断率，并且能够更精确地诊断局灶性病变。
