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| B超或CT引导下肝脏肿块穿刺细胞学与组织学对比分析 |
| The preliminary comparative analysis about cytological and histological for liver biopsy obtained by B-type ultrasound or CT guided biopsy |
| 投稿时间：2015-05-15 修订日期：2015-07-01 |
| DOI：10.3969/j.issn.1000-0399.2015.08.015 |
| 中文关键词: 肝脏穿刺活检 细胞学 组织学 B超 CT |
| 英文关键词: Liver biopsy Cytology Histology B-type ultrasound CT |
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| 中文摘要: |
| 目的 对B超或CT引导下经皮肝脏肿块细针穿刺标本进行细胞学与组织学对比分析,探讨其临床应用价值。方法 回顾性分析2006年1月至2014年12月行B超或CT引导下经皮肝脏穿刺活检并经手术病理、影像学及甲胎蛋白(AFP)标准、随访观察证实的60例肝脏占位性病例临床资料。结果 60例肝脏肿块经手术病理、影像学及AFP标准、随访观察证实为恶性肿瘤55例,良性病变5例。穿刺病理组织学提示恶性肿瘤55例,良性病变5例;细胞学提示恶性肿瘤53例,良性病变7例。与组织学诊断结果比较,细胞学诊断恶性肿瘤的灵敏度为:96.4%(53/55),特异度为:100%(5/5),阳性预测值为100%(53/53),阴性预测值为71.4%(5/7),约登指数为0.96。组织学与细胞学诊断符合率为96.7%。结论 B超或CT引导下经皮肝脏肿块穿刺活检的是一种准确而又安全的微创诊断方法,组织学和细胞学检查各有优势,建议临床穿刺活检时同时进行组织学和细胞学的检查, 可以显著提高诊断的敏感性, 更准确地对肝脏占位性病变做出确切诊断。 |
| 英文摘要: |
| Objective To evaluate the clinical diagnostic value of cytological and histological analysis of the liver lesions biopsy specimens obtained by B-type ultrasound or CT guided biopsy. Methods From Jan 2006 to Sep 2014, clinical records of a total of 60 patients with liver lesions who underwent percutaneous liver biopsy guided by CT or B-type ultrasound were reviewed and analysed, and all patients were confirmed by pathology, imaging and AFP level, together with observation follow-up. Results By pathology, imaging, AFP level and observation follow-up, 55 cases of malignant and 5 cases of benign lesions were confirmed. Among 60 cases of liver lesions biopsy specimens obtained successfully, histological analysis was indicative of malignant tumors in 55 cases, benign lesions in 5 cases; cytological analysis indicative of malignancy in 53 cases, benign lesions in 7 cases. For malignant liver tumors, the sensitivity is 96.4%, specificity is 100%, positive predictive value is 100%, negative predictive value is 71.4%(5/7), Youden index 0.96, coincidence rate is 96.7%, the difference between the two groups was not statistically significant (P >0.05). Conclusion The B-type ultrasound or CT guided percutaneous biopsy of liver lesions is an accurate and safe, minimally invasive diagnostic method, and histological and cytological examinations have their respective advantages, so it is recommended to combine the examinations with clinical liver biopsy to significantly improve the diagnostic sensitivity, which is beneficical to the early definitive diagnosis of hepatic space-occupying lesions. |
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