Andersson R, Andrén-Sandberg A, Lundstedt C, Tranberg K G
Department of Surgery, Lund University Hospital, Sweden.
Eur J Surg. 1996 Jul;162(7):551-4.
Evaluation of incidence and outcome of implantation metastases after percutaneous fine-needle biopsy or biliary drainage.
Retrospective study.
University hospital, Sweden.
Eight patients with implantation metastases from gastrointestinal cancers after percutaneous fine-needle biopsy (n = 7) or biliary drainage (n = 1).
Incidence of implantation metastases, treatment and influence on outcome and survival.
In two out of three patients who had had otherwise radical operations, the implantation metastases meant that the operations were palliative rather than curative. Patients who had had palliative resections of the implantation metastases developed major local complications. One patient is alive with no signs of disease after 106 months, while one is alive with disease 30 months after the diagnosis of the implantation metastases. The remaining patients have died after 6 to 23 months.
The incidence of implantation metastases after fine-needle procedures is probably underestimated. There is a slight but definite risk that the procedure may render an otherwise curative resection palliative. Implantation metastases cause local complaints of varying severity and seems to have a tendency to recur locally. We recommend that fine-needle biopsy should be restricted to patients who will truly benefit from a more accurate preoperative diagnosis.
评估经皮细针穿刺活检或胆道引流术后种植转移的发生率及转归。
回顾性研究。
瑞典大学医院。
8例经皮细针穿刺活检（7例）或胆道引流（1例）后发生胃肠道癌种植转移的患者。
种植转移的发生率、治疗方法及其对转归和生存的影响。
在3例原本接受根治性手术的患者中，有2例因种植转移导致手术由根治性变为姑息性。接受姑息性切除种植转移灶的患者出现了严重的局部并发症。1例患者在106个月后无疾病迹象存活，另1例在诊断种植转移后30个月带瘤存活。其余患者在6至23个月后死亡。
细针穿刺操作后种植转移的发生率可能被低估。该操作存在轻微但确切的风险，可能使原本可根治的切除手术变为姑息性手术。种植转移会引起不同程度的局部症状，且似乎有局部复发的倾向。我们建议细针穿刺活检应仅限于真正能从更准确的术前诊断中获益的患者。
