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中华医学超声杂志(电子版) ›› 2017, Vol. 14 ›› Issue (10) : 794 -798. doi: 10.3877/cma.j.issn.1672-6448.2017.10.015

所属专题: 文献

妇产科超声影像学

超声引导细针穿刺细胞病理学对卵巢肿瘤及腹膜后转移性淋巴结的临床诊断价值
刘俊平1,(), 毛伟敏2, 徐栋3, 徐海苗4, 程晔4, 楼寒梅2, 陈丽羽5, 吕敏5, 程芳5   
  1. 1. 310022 杭州,浙江省肿瘤医院介入超声科;浙江省胸部肿瘤(食管、肺)诊治技术研究重点实验室
    2. 浙江省胸部肿瘤(食管、肺)诊治技术研究重点实验室
    4. 310022 杭州,浙江省肿瘤医院病理科
    5. 310022 杭州,浙江省肿瘤医院妇科肿瘤
  • 收稿日期:2016-12-18 出版日期:2017-10-01
  • 通信作者: 刘俊平

Value of ultrasound-guided fine needle aspiration cytology in the assessment of ovarian neoplasms and retroperitoneal metastatic lymph nodes

Junping Liu1,(), Weimin Mao2, Dong Xu3, Haimiao Xu4, Ye Cheng4, Hanmei Lou2, Liyu Chen5, Min Lyu5, Fang Cheng5   

  1. 1. Department of Interventional Ultrasound, Zhejiang Cancer Hospital, Hangzhou 310022, China; Zhejiang Key Laboratory of the Diagnosis & Treatment Technology on Thoracic Oncology, Hangzhou 310022, China
    2. Zhejiang Key Laboratory of the Diagnosis & Treatment Technology on Thoracic Oncology, Hangzhou 310022, China
    3. Department of Interventional Ultrasound, Zhejiang Cancer Hospital, Hangzhou 310022, China; Department of Gynecologic Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China
    4. Department of Pathology, Zhejiang Cancer Hospital, Hangzhou 310022, China
    5. Department of Gynecologic Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China
  • Received:2016-12-18 Published:2017-10-01
  • Corresponding author: Junping Liu
  • About author:
    Corresponding author: Liu Junping, Email:
引用本文:

刘俊平, 毛伟敏, 徐栋, 徐海苗, 程晔, 楼寒梅, 陈丽羽, 吕敏, 程芳. 超声引导细针穿刺细胞病理学对卵巢肿瘤及腹膜后转移性淋巴结的临床诊断价值[J/OL]. 中华医学超声杂志(电子版), 2017, 14(10): 794-798.

Junping Liu, Weimin Mao, Dong Xu, Haimiao Xu, Ye Cheng, Hanmei Lou, Liyu Chen, Min Lyu, Fang Cheng. Value of ultrasound-guided fine needle aspiration cytology in the assessment of ovarian neoplasms and retroperitoneal metastatic lymph nodes[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(10): 794-798.

目的

探讨超声引导细针穿刺细胞病理学(US-FNAC)检查在卵巢肿瘤及腹膜后转移性淋巴结的临床诊断价值。

方法

选取2012年1月至2016年6月在浙江省肿瘤医院行卵巢肿瘤与腹膜后转移性淋巴结US-FNAC患者126例,穿刺后的细胞学涂片行HE染色,以外科手术病理组织学与临床随访为"金标准",计算敏感度、特异度、准确度、阳性预测值及阴性预测值。

结果

穿刺获得的样本满意率为86.2%,获得病理学诊断的占85.7%。在腹膜后的淋巴结穿刺中,93.5%结节的最短径<20 mm。FNAC诊断卵巢肿瘤及腹膜后转移性淋巴结的敏感度为81.6%、86.2%、特异度为95.8%、100.0%、准确性为85.3%、87.1%、阳性预测值为98.3%、100.0%及阴性预测值为63.9%、33.3%。7例出现腹部轻微不适,未临床处理自行缓解。

结论

在卵巢肿瘤及腹膜后转移性淋巴结的诊断中,US-FNAC具有较高的阳性预测值,且安全准确有效,推荐应用于卵巢肿瘤患者的临床诊断。

Objective

To evaluate the diagnostic value of ultrasound-guided fine needle aspiration cytology(US-FNAC)in the assessment of radiologically detected ovarian neoplasms and retroperitoneal metastatic lymph nodes.

Methods

FNAC was performed under ultrasound guidance on 126 patients suspected of ovarian neoplasms and retroperitoneal metastatic lymph nodes. Cytologic examination was performed after staining smears with the haematoxylin and eosin method. Clinical data were retrieved from the medical records and all cytological specimens were reviewed. In these cases, the cytologic findings were correlated with histology of the primary tumor and were compared with surgical pathology.

Results

Satisfactory sampling was obtained in 86.2% of punctures, and cytological diagnosis was made in 85.7% cases. The size of the lymph nodes punctured was less than 20 mm in 93.5% cases, with the sensitivity of 81.6%、86.2%, specificity of 95.8%、100.0%, positive predictive value of 98.3%、100.0%, negative predictive value of 63.9%、33.3%, and accuracy of 85.3%、87.1%. Seven patients presented slight abdominal discomfort, and relieved without clinical treatment.

Conclusions

The fine needle aspiration technique has excellent positive predictive value and low morbidity. US-FNAC, as the valuable investigation, is not only useful in the diagnosis of ovarian masses and lymph nodes but can also help in choosing appropriate management. From our experience, US-FNAC can be added in follow-up of selected patients in whom the cytological identification of such masses and nodes is significant for the patient′s treatment.

图2 二维超声示盆腔内囊实性肿块,大小约65 mm×54 mm,边缘欠光整,超声引导下穿刺针位于肿块实性部分,针道显示清楚
表1 超声引导细针穿刺细胞病理学对卵巢肿瘤的诊断价值
表2 超声引导细针穿刺细胞病理学对腹膜后淋巴结的诊断价值
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