Fornari F, Filice C, Rapaccini G L, Caturelli E, Cavanna L, Civardi G, Di Stasi M, Buscarini E, Buscarini L
I Divisione di Medicina, Servizio di Gastroenterologia, Ospedale di Piacenza, Italy.
Dig Dis Sci. 1994 Oct;39(10):2267-75. doi: 10.1007/BF02090383.
Three hundred ninety-five consecutive patients with sonographically detected hepatic lesions < or = 3 cm in diameter were submitted to ultrasonically guided fine-needle biopsy: 24 (6.1%) were < or = 1 cm in diameter; 142 (36%) were between 1.1 and 2 cm, and 229 (57.9%) were between 2.1 and 3 cm in diameter. In the 385 controlled cases, we obtained a cytohistological diagnosis of malignancy in 243 (63.1%): 135 hepatocellular carcinomas, 97 metastases, and 11 hepatic lymphomas. There were 104 true negatives (27%) and 38 false negatives (9.9%). The sensitivity of ultrasonically guided fine needle biopsy in the total series was 86.5%, the specificity 100%, with an overall accuracy of 90.1%. The overall accuracy was higher for lesions between 2.1 and 3 cm in diameter (90%) and was lower for lesions located in the sixth segment (84.6%). The correct diagnosis was obtained in the 83.3% (135/162) of small hepatocellular carcinomas versus 89.8% (97/108) in cases of small metastatic lesions.
395例经超声检查发现直径≤3cm肝脏病变的连续患者接受了超声引导下细针穿刺活检：其中直径≤1cm的有24例（6.1%）；直径在1.1至2cm之间的有142例（36%），直径在2.1至3cm之间的有229例（57.9%）。在385例对照病例中，我们获得了243例（63.1%）恶性病变的细胞组织学诊断结果：135例肝细胞癌，97例转移瘤，11例肝淋巴瘤。有104例假阴性（27%）和38例假阳性（9.9%）。超声引导下细针穿刺活检在整个系列中的敏感性为86.5%，特异性为100%，总体准确率为90.1%。直径在2.1至3cm之间的病变总体准确率较高（90%），而位于第六段的病变总体准确率较低（84.6%）。小肝细胞癌的正确诊断率为83.3%（135/162），而小转移瘤病例的正确诊断率为89.8%（97/108）。
