Herszenyi L, Farinati F, Cecchetto A, Marafin C, de Maria N, Cardin R, Naccarato R
Cattedra Malattie Apparato Digerente, Istituto di Medicina Interna, Universita di Padova, Italy.
Ital J Gastroenterol. 1995 Dec;27(9):473-8.
We evaluated the diagnostic usefulness of 244 ultrasound-guided fine-needle biopsies (FNB) in 226 patients with suspected liver malignancies. A malignancy was detected in 166 cases (73%) -145 hepatocellular carcinomas (HCC), 21 metastases; benign lesions were aspirated in 60 cases (27%). The sensitivity of FNB was 93%, with 100% specificity. In the FNB false-negative cirrhotic nodules, a final diagnosis of HCC was reached on repeating the biopsy 1-8 months later. When both cytological and microhistological examinations were performed, the positive correlation between the two techniques was 80%, with a slightly higher sensitivity for microhistology (93%). The malignancies diagnosed were potentially resectable in 26% of cases. We experienced 1 acute complication of FNB and 1 case of needle tract tumour seeding. These results confirm that FNB is useful in diagnosing malignant liver tumours. We believe that US-guided FNB is the first-choice invasive technique for assessing focal benign lesions and malignant tumors in the liver.
我们评估了244例超声引导下细针穿刺活检（FNB）对226例疑似肝脏恶性肿瘤患者的诊断价值。166例（73%）检测到恶性肿瘤，其中145例为肝细胞癌（HCC），21例为转移瘤；60例（27%）穿刺到良性病变。FNB的敏感性为93%，特异性为100%。在FNB假阴性的肝硬化结节中，1至8个月后重复活检最终确诊为HCC。当同时进行细胞学和微组织学检查时，两种技术的阳性相关性为80%，微组织学的敏感性略高（93%）。确诊的恶性肿瘤中26%的病例可能可切除。我们经历了1例FNB急性并发症和1例针道肿瘤种植。这些结果证实FNB对诊断肝脏恶性肿瘤有用。我们认为超声引导下FNB是评估肝脏局灶性良性病变和恶性肿瘤的首选侵入性技术。
