超声引导下经皮穿刺活检对颈部淋巴结病变诊断的应用价值  

Application of pathological diagnosis by using ultrasound-guided percutaneous biopsy for cervical lymph lesions

作　　者：朱晓琳[1] 崔玥婵[2] 侯文静[2] 张晟[1] 徐勇[1] 魏玺[1] 忻晓洁[1] 王海玲[1] 张雪君[2] 

机构地区：[1]天津医科大学附属肿瘤医院（天津市“肿瘤防治”重点实验室）超声诊断治疗科,300060 [2]天津医科大学影像学院

出　　处：《国际肿瘤学杂志》2012年第1期72-75,共4页Journal of International Oncology

摘　　要：目的探讨超声引导下经皮穿刺活检（PNCB）对颈部淋巴结病变病理学诊断中的临床应用价值。方法210例患者行超声引导下PNCB，穿刺标本送病理学检测，与手术切检病理诊断结果对比。结果210例患者超声引导下PNCB后，一次性取材满意率98．6％（207／210），92．9％（195／210）可做出病理学诊断，良、恶性病变诊断准确率99．4％（194／195）。超声引导下PNCB诊断转移瘤敏感性为96．4％（135／140），诊断淋巴瘤敏感性86．1％（31／36），仅67．7％（21／31）淋巴瘤可作出具体分型。结论超声引导下PNCB检测颈部淋巴结良、恶性病变的诊断率高，创伤小，可代替手术切检。但由于淋巴瘤病理类型复杂，必要时仍需进行手术切检，确定诊断及分型。Objective To evaluate the clinical application value of pathological diagnosis by using ultrasound-guided percutaneous needle core biopsy （PNCB） for cervical lymph lesions. Methods Two hundred and ten patients with cervical lymph lesions underwent ultrasound-guided PNCB, and pathological diagnosis were made based on core biopsy material. The results of study were concluded by comparing the pathological diagnosis from core biopsy of the lymph nodes with those from excision biopsy. Results There were 210 patients underwent ultrasoundguided PNCB, 98.6% （207/210） cases of core biopsies yielded adequate material at first time and 92.9% （195/210） cases of those had pathologic diagnosis. The accuracy of ultrasound-guided PNCB in differentiating benign from malignant lymphadenopathy was 99.4% （ 194/195 ）. The diagnostic accuracy of metastatic tumor and lymphoma by ultrasound-guided PNCB was 96.4% （135/140） and 86. lifo （31/36）, respectively. Only 67.7% （21/31） patients with lymphoma could be classified by ultrasound-guided PNCB. Conclusion Ultrasound-guided PNCB in patients with neck lymph lesions is a safe, convenient and quick procedure that has a high diagnosis accuracy. Ultrasound-guided PNCB can replace the open surgery for neck lymph node diagnostic method. Due to the complicated and diverse pathologic performance, lymphoma should be cut by open surgery to confirm the diagnosis and classification.

关 键 词：诊断技术和方法 活组织检查 颈部淋巴结病变 

分 类 号：R445.1[医药卫生—影像医学与核医学]