芯针活检在儿科肿块性疾病病理诊断中的应用  

Needle biopsies in pediatric tumors

作　　者：汤宏峰[1] 唐达星[2] 顾伟忠[1] 林隆[1] 舒燕[1] 赵云[1] 李民驹[2] 

机构地区：[1]浙江大学医学院附属儿童医院病理科,杭州310003 [2]浙江大学医学院附属儿童医院肿瘤外科,杭州310003

出　　处：《中华小儿外科杂志》2007年第8期393-396,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的评价芯针活检在儿科肿块性疾病病理诊断中的价值及提高病理诊断准确性并作出具体分类的对策。方法用光镜、免疫组织化学技术观察201例儿科肿块性疾病穿刺组织的形态和免疫组织化学表型,个别病例同时作透射电镜观察,并对其诊断价值作分析。结果201例患儿穿刺后有诊断价值的178例(88.6%);123例恶性肿瘤中常规染色能分类仅61)例(48.8%),结合免疫组化结果有99例(80.5%)得到分类及分型;无法分类的13例进行了电镜检查,5例找到诊断性的超微结构。92例最终作肿块手术切除或手术活检,病理诊断前后完全符合的82例(89.1%)。结论儿童肿块性疾病芯针活检简便易行、准确率高,对正确制定治病方案具有重要的指导作用。但病理诊断时要结合临床和影像资料,多做鉴别诊断;并选择适当的足够的抗体作免疫组化分析,必要时作透射电镜检查才能提高诊断正确性。Objective To assess the efficacy of needle biopsy in the pathological diagnoses of the pediatric turnors. Methods Two hundred and one needle biopsy specimens of pediatric tumors were studied retrospectively with light microscopy and？ immunohistochemistry. Transmission electron microscope （TEM） studies were performed in some of the specimens. The diagnostic value was analyzed. Results Morphologically, 178 out of 201 needle biopsy specimens （88. 6%） were proven to have diagnostic value. Only 60 out of 123 malignant tumors （48. 8% ） could be classified with hematoxylin and eosin （HE） staining. With additional immunohistochemical staining, diagnosis could be reached in 99 cases （80. 5%）. TEM were helpful in 5 out of the 13 specimen of which the diagnoses were not conclusive. Open biopsy and tumor resection following needle biopsy were performed in 92 cases. The accuracy rate of the pre-op diagnoses was 89% （82/92）. Conclusions The needle biopsy in pediatric tumors has a high diagnostic accuracy rate. The accuracy rate could be further improved by TEM.

关 键 词：活组织检查 针吸 诊断 鉴别 

分 类 号：R446.8[医药卫生—诊断学]