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超声引导下核心针活检在腮腺肿瘤术前评估中的诊断准确性及术后并发症。

Diagnostic Accuracy and Post-Procedural Complications Associated with Ultrasound-Guided Core Needle Biopsy in the Preoperative Evaluation of Parotid Tumors.

机构信息

Department of Otolaryngology, Head and Neck Surgery, Medical Faculty, University Hospital Augsburg, University of Augsburg, Sauerbruchstaße 6, 86156, Augsburg, Germany.

Department of Otolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Straße 62, 50931, Cologne, Germany.

出版信息

Head Neck Pathol. 2022 Sep;16(3):651-656. doi: 10.1007/s12105-021-01401-w. Epub 2021 Dec 17.

Abstract

Correct diagnosis of a parotid neoplasm based on histology preoperatively is of utmost importance in order to guide patient management. The aim of this study was to evaluate the diagnostic accuracy of an ultrasound-guided core needle biopsy of a parotid lesion and to describe associated post-procedural complications. A retrospective study was conducted between January 2015 and March 2021 of all patients who were referred to a tertiary care center for evaluation of a parotid lesion and who underwent core needle biopsy due to high-risk features or when malignancy was suspected on clinical examination or ultrasonography. Patient characteristics, histological findings, and post-procedural complications were recorded and evaluated. Among 890 patients referred for evaluation of a parotid lesion, in 138 patients a core needle biopsy was undertaken. On the basis of core needle biopsy findings, 11 lymphomas and 82 non-lymphoma malignancies were diagnosed in the parotid gland. The sensitivity of the core needle biopsy predicting the accurate tumor type was 97.56% (95% CI 91.47-99.70%) and the specificity 94.64% (95% CI 85.13-98.88%). The accuracy for the correct histopathological diagnosis was 93.48% (95% CI 87.98-96.97%). Post-procedural minor complications occurred in 19 patients (13.8%). In conclusion, a core needle biopsy can identify malignancy in the parotid gland with high sensitivity and specificity in a safe manner and therefore guide surgical treatment.

摘要

基于组织病理学术前正确诊断腮腺肿瘤对于指导患者管理至关重要。本研究旨在评估超声引导下腮腺病变核心针活检的诊断准确性,并描述相关的术后并发症。对 2015 年 1 月至 2021 年 3 月期间因高危特征或临床检查或超声检查怀疑恶性肿瘤而转诊至三级医疗中心评估腮腺病变并接受核心针活检的所有患者进行了回顾性研究。记录并评估了患者特征、组织学发现和术后并发症。在 890 例因腮腺病变就诊的患者中,有 138 例患者接受了核心针活检。根据核心针活检结果,在腮腺中诊断出 11 例淋巴瘤和 82 例非淋巴瘤恶性肿瘤。核心针活检预测准确肿瘤类型的敏感性为 97.56%(95%CI 91.47-99.70%),特异性为 94.64%(95%CI 85.13-98.88%)。正确的组织病理学诊断的准确性为 93.48%(95%CI 87.98-96.97%)。19 例患者(13.8%)发生术后轻微并发症。总之,核心针活检可以安全地以高敏感性和特异性识别腮腺中的恶性肿瘤,从而指导手术治疗。

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