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经皮计算机断层扫描引导下活检足以确诊惰性淋巴瘤转化吗?

Is percutaneous computed tomography-guided biopsy sufficient to establish indolent lymphoma transformation?

作者信息

Dvorak Petr, Hoffmann Petr, Simkovic Martin, Jandura Jiri, Nova Marketa

机构信息

Department of Radiology, University Hospital, Hradec Kralove, Czech Republic.

4 Department of Internal Medicine - Hematology, University Hospital, Hradec Kralove, Czech Republic.

出版信息

Arch Med Sci. 2019 Oct;15(6):1443-1453. doi: 10.5114/aoms.2018.79573. Epub 2018 Dec 31.

Abstract

INTRODUCTION

The aim of the study was to retrospectively evaluate the technical features, efficacy, accuracy, and relevant complications of computed tomography-guided biopsies in various anatomical localizations when diagnosing indolent lymphoma transformations, relapses, duplicate malignant diseases or benign processes.

MATERIAL AND METHODS

From December 2007 to December 2017, 81 percutaneous biopsy procedures in 72 patients for tumors, sizes 17-232 mm in diameter (median length: 39 mm), were performed in patients with known indolent lymphomas in their clinical history. The patients were men in 41 cases and women in 31 cases, aged 36 to 86 years.

RESULTS

In 79 cases (97.5%; 95% CI: 91.3-99.7) results were true positive or true negative; only 2 interventions (2.5%; 95% CI: 0.3-8.6) were histologically false negative. Transformation was verified in 29 cases (35.8%; 95% CI: 25.4-47.2), relapses in 30 cases (37%; 95% CI: 26.6-48.5), duplicate malignancy in 15 cases (18.5%; 95% CI: 10.8-28.7) and benign processes in 7 cases (8.7%; 95% CI: 3.5-17.0). Eight complications in total were revealed, 7 of which were in consequence of thoracic cavity biopsy. A statistically significant relationship between the complication incidence and anatomical localization in the thoracic cavity was identified ( = 0.0104).

CONCLUSIONS

Percutaneous CT guided biopsy performed in patients with a history of indolent lymphoma had high accuracy in establishing the correct diagnosis regarding transformation, relapse, duplicate malignancy or a benign process. Simultaneously, the complication rate was low.

摘要

引言

本研究的目的是回顾性评估计算机断层扫描引导下活检在诊断惰性淋巴瘤转化、复发、重复恶性疾病或良性病变时,在不同解剖部位的技术特点、疗效、准确性及相关并发症。

材料与方法

2007年12月至2017年12月,对72例有惰性淋巴瘤病史的患者进行了81次经皮活检,肿瘤直径17 - 232mm(中位长度:39mm)。患者中男性41例,女性31例,年龄36至86岁。

结果

79例(97.5%;95%可信区间:91.3 - 99.7)结果为真阳性或真阴性;仅2例干预(2.5%;95%可信区间:0.3 - 8.6)组织学结果为假阴性。29例(35.8%;95%可信区间:25.4 - 47.2)证实为转化,30例(37%;95%可信区间:26.6 - 48.5)为复发,15例(18.5%;95%可信区间:10.8 - 28.7)为重复恶性肿瘤,7例(8.7%;95%可信区间:3.5 - 17.0)为良性病变。共发现8例并发症,其中7例因胸腔活检所致。胸腔内并发症发生率与解剖部位之间存在统计学显著相关性( = 0.0104)。

结论

对有惰性淋巴瘤病史的患者进行经皮CT引导下活检,在确定转化、复发、重复恶性肿瘤或良性病变的正确诊断方面具有较高准确性。同时,并发症发生率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5cd/6855164/c8e9a221be38/AMS-15-34134-g001.jpg

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