一种新型穿刺活检针在骨与软组织肿瘤诊断中的临床应用  

Clinical application of a new type of biopsy needle in the diagnosis of bone and soft tissue tumors

作　　者：尹军强[1] 沈靖南[1] 黄纲[1] 王晋[1] 谢显彪[1] 邹昌业[1] 王永谦[1] 雍碧城[1] 王博[1] 

机构地区：[1]中山大学附属第一医院骨肿瘤科,广州510080

出　　处：《中华关节外科杂志（电子版）》2012年第3期16-19,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的评价思特利穿刺活检针在骨与软组织肿瘤诊断中的应用。方法回顾性总结2011年9月到2012年3月期间,本组应用思特利穿刺活检针对132例患者施行肿瘤穿刺,比较研究穿刺病理结果和术后病理结果。结果在132例患者中,共进行133次(其中一例两个部位)初次穿刺,8人接受2次穿刺,首次穿刺结果阳性率为89.5%(119/133),8例再次穿刺后,阳性率提高为95.5%(127/133)。121例穿刺活检结果与最终手术病理结果相符,准确率91.6%(121/132)。其中,骨内实性组织取材99例,穿刺结果的阳性率95.0%(94/99),准确率为93.0%(92/99);骨内溶骨性组织取材21例,穿刺结果的的阳性率与准确率均为85.7%(18/21);软组织取材12例,穿刺结果的阳性率与准确率均为92.0%(11/12);恶性骨与软组织肿瘤穿刺活检的敏感性及特异性分别为97.3%(70/73)及100%(59/59),阳性预测值100%(71/71),阴性预测值96.7%(59/61)。结论思特利穿刺活检针安全、有效,具有很高的穿刺活检阳性及准确率,尤其在骨内实性组织取材中具有明显的优势。Objective To investigate the diagnostic accuracy of Sterylab biopsy needle in bone and soft tissue tumors. Methods We retrospectively studied 132 patients who underwent both biopsy and surgery in First Affiliated Hospital of Sun Yat-Sen University between September 2011 and March 2012. Sterylab needle was adopted in all biopsies. The histological diagnosis before and after definitive surgery was compared. Results Among 132 patients, there were 133 biopsies. Eight patients accepted secondary biopsies. The sensitivity was 90. 0% （119/133 ） for one-biopsy. Two-biopsies had a sensitivity of 95. 5% （127/133）. The biopsy diagnosis of 121 cases was consistent with their postoperative pathological report, and the diagnostic accuracy was 91.6% （121/132）. Among these, 99 biopsies included solid tissues. The sensitivity and accuracy of diagnosis were 95.0% （94/99） and 93.0% （92/99） , respectively. 21 biopsies included osteolytic tissues, which had a sensitivity of 85.7% （ 18/21 ） , an accuracy of 85.7% （18/21）. There were 12 biopsies including soft tissue, and the diagnostic sensitivity and accuracy were 92. 0% （11/12） and 92. 0% （11/12）. The sensitivity and specificity were 97.3% （70/73） and 100% （59/59） in malignant bone and soft tissue tumor biopsies, and the positive predictive value and negative predictive value were 100% （71/71） and 96.7% （59 /61 ） respectively. Conclusions Using Sterylab needle to establish the biopsy tract is a safe and effective method with high sensitivity and specificity rate, especially in solid lesions.

关 键 词：骨肿瘤 软组织肿瘤 活组织检查 针吸 诊断 

分 类 号：R738[医药卫生—肿瘤]