Pontifex A H, Klimo P
Cancer. 1984 Feb 1;53(3):553-6. doi: 10.1002/1097-0142(19840201)53:3<553::aid-cncr2820530330>3.0.co;2-m.
Fine needle aspiration diagnosis is a well established technique. However, its application to lymphomas has been quite limited. From September 1977 to January 1981, the Lymphoma Group at the CCABC performed 213 aspirates. Of the 213, 180 were considered to be diagnostically useful, with 33 being unsatisfactory or no action was taken. Of the 180 considered useful, 170 were positive, and prompted institution of therapy (84), provided guide to appropriate treatment (84), provided rapid solution to clinical situation (65), provided improved understanding of clinical situation (78), and prevented invasive procedure [minor (local anesthetic), 31; intermediate (general anesthetic), 88; major (laparotomy or thoracotomy), 18]. Ten negative results delayed therapy (3), led to unnecessary or inappropriate investigation (1), led to incorrect therapy, (4), and were a source of confusion (10). In most circumstances, the authors tried to avoid fine needle aspirations as the only basis for an initial diagnosis. In a previously diagnosed lymphoma, aspiration aided in staging, in confirming recurrence, in the diagnosis of new and unrelated malignancy or undiagnosed infection and in assessing the evolution of a lymphoma to a more aggressive form. Aspiration diagnosis was considered to be a useful adjunct in the care of patients with lymphoma and it is especially suited to use by a closely working team of clinicians, radiologists, and pathologists.
细针穿刺诊断是一项成熟的技术。然而,其在淋巴瘤中的应用一直相当有限。1977年9月至1981年1月,CCABC的淋巴瘤研究小组进行了213次穿刺。在这213次穿刺中,180次被认为对诊断有用,33次不满意或未采取任何措施。在180次被认为有用的穿刺中,170次呈阳性,并促使开始治疗(84次),为适当治疗提供指导(84次),迅速解决临床情况(65次),增进对临床情况的了解(78次),并避免了侵入性操作[轻微(局部麻醉),31次;中等(全身麻醉),88次;严重(剖腹术或开胸术),18次]。10次阴性结果导致治疗延迟(3次),导致不必要或不适当的检查(1次),导致错误的治疗(4次),并造成混淆(10次)。在大多数情况下,作者尽量避免将细针穿刺作为初始诊断的唯一依据。在先前诊断的淋巴瘤中,穿刺有助于分期、确认复发、诊断新的和无关的恶性肿瘤或未诊断的感染,以及评估淋巴瘤向更具侵袭性形式的演变。穿刺诊断被认为是淋巴瘤患者护理中的一项有用辅助手段,尤其适合由临床医生、放射科医生和病理学家组成的紧密合作团队使用。