Knapp I, Mann W, Wachter W
Universitäts-Hals-Nasen-Ohren-Klinik Freiburg.
Laryngorhinootologie. 1989 Dec;68(12):683-9. doi: 10.1055/s-2007-998430.
From October 1985 to July 1988 we performed a study to examine 106 patients with head and neck tumours, by using ultrasound as a guiding system for fine-needle aspiration biopsy. It could be shown that this method has a high diagnostic significance at the neck with a low rate of risks. In a first step puncture was effected to obtain material for cytology, if necessary also for a bacteriological examination. Normally, in a second step a fine-needle cutting biopsy was done to obtain histological material. The combined use of aspiration and cutting needle biopsy achieved correct tumour status in 91.5%, whereas in 73.6% the correct type of lesion was diagnosed. A false status assessment and errors in identifying the lesions occurred in 2 of 106 cases; there of was one false negative status assessment. In cases of benign neck cysts, neck abscesses and non-specific lymphadenopathy, a cutting neck biopsy is not required, provided the clinical diagnosis is in accordance with the result of aspiration cytology and the further clinical progress. The advantage of the ultrasound-guided puncture compared with palpation-guided puncture is the certainty of locating the region of interest even in deep lesions without an appreciable risk of complications. In our opinion, ultrasound-guided fine needle aspiration biopsy is indicated in all cases of unclear head and neck tumours which could be treated conservatively if the result of the puncture is non-malignant.
1985年10月至1988年7月，我们开展了一项研究，对106例头颈部肿瘤患者进行了检查，采用超声作为细针穿刺活检的引导系统。结果表明，该方法在颈部具有较高的诊断价值，且风险率较低。第一步进行穿刺以获取细胞学检查材料，必要时也用于细菌学检查。通常情况下，第二步进行细针切割活检以获取组织学材料。抽吸活检和切割针活检联合使用在91.5%的病例中明确了肿瘤状态，而在73.6%的病例中诊断出了正确的病变类型。106例中有2例出现了错误的状态评估和病变识别错误；其中有1例假阴性状态评估。对于良性颈部囊肿、颈部脓肿和非特异性淋巴结病，如果临床诊断与抽吸细胞学结果及进一步的临床进展相符，则无需进行颈部切割活检。与触诊引导穿刺相比，超声引导穿刺的优势在于即使对于深部病变也能确定感兴趣区域的位置，且并发症风险较小。我们认为，对于所有不明原因的头颈部肿瘤病例，如果穿刺结果为非恶性且可保守治疗，均应采用超声引导下细针抽吸活检。
