Kalra A, Prucher G-M, Hodges S
Department of Oral and Maxillofacial Surgery, King's College Hospital , London , UK.
Ann R Coll Surg Engl. 2019 Mar;101(3):193-196. doi: 10.1308/rcsann.2018.0201. Epub 2018 Nov 28.
King's College Hospital has proudly provided a one-stop neck lump clinic since 2012. These multidisciplinary clinics allow for rapid diagnoses due to in-clinic investigations. In April 2013, ultrasound-guided core needle biopsies were introduced as an alternative/adjunct to fine-needle aspiration cytology and open biopsies for obtaining histological diagnoses. The aim of the study was to assess the impact of core needle biopsies on the diagnosis of neck lumps compared with fine-needle aspiration cytology and open biopsies between April 2015 and May 2016.
Data were collected prospectively between April 2015 and May 2016 and analysed for numbers of fine-needle aspiration cytology, core needle biopsies and open biopsies performed and diagnoses made.
A total of 190 patients were seen on the clinic; 51 had fine-needle aspiration cytology and 19 procedures gave a diagnosis. Of the remainder of these patients, 21 went on to have a core needle biopsy and 12 biopsies gave a diagnosis. An additional eight patients only had a core needle biopsy, of which five biopsies gave a diagnosis. Of the ten patients who had an open biopsy, four had a previous fine-needle aspiration cytology and core needle biopsy, three only a core needle biopsy, two had neither and one had fine-needle aspiration cytology.
The introduction of core needle biopsies has reduced the number of open biopsies performed. With increasing acceptance of this minimally invasive technique, core needle biopsies appear to be forming the key diagnostic investigation in patients with neck lumps.
自2012年以来,国王学院医院一直自豪地提供一站式颈部肿块诊所服务。这些多学科诊所由于进行了门诊检查,能够实现快速诊断。2013年4月,超声引导下的粗针活检被引入,作为细针穿刺抽吸细胞学检查和开放活检的替代/辅助方法,用于获取组织学诊断。本研究的目的是评估2015年4月至2016年5月期间,与细针穿刺抽吸细胞学检查和开放活检相比,粗针活检对颈部肿块诊断的影响。
前瞻性收集2015年4月至2016年5月的数据,分析细针穿刺抽吸细胞学检查、粗针活检和开放活检的执行数量以及做出的诊断。
该诊所共接待了190例患者;51例接受了细针穿刺抽吸细胞学检查,其中19例检查得出了诊断结果。在其余患者中,21例继续接受粗针活检,其中12例活检得出了诊断结果。另外8例患者仅接受了粗针活检,其中5例活检得出了诊断结果。在接受开放活检的10例患者中,4例之前接受过细针穿刺抽吸细胞学检查和粗针活检,3例仅接受过粗针活检,2例两者都未接受过,1例接受过细针穿刺抽吸细胞学检查。
粗针活检的引入减少了开放活检的执行数量。随着这种微创技术越来越被接受,粗针活检似乎正在成为颈部肿块患者的关键诊断检查方法。