目的：评价CT引导下经皮穿刺活检肺内小结节病灶的诊断价值。方法：在CT导向下穿刺活检肺内直径≤2 cm的孤立性的小结节病灶51例，作细胞学和组织学的检查。结果:本组51例共行58次穿刺活检，24例获得细胞学涂片检查，39例获得组织学检查。诊断准确率82.3%（42/51）。并发症主要为肺出血和气胸，其发生率分别为21.6%（11/51）和13.7%（7/51）。结论：CT导向下穿刺活检肺内小结节病灶的诊断确诊率高，并发症轻。可作为一种常规检查手段。
Objective To evaluate the application value of intraocular biopsy in the diagnosis of atypical intraocular lesions. Methods The clinical data of 31 patients (31 eyes) with atypical intraocular lesions were retrospectively analyzed. All patients received intraocular biopsy including anterior chamber puncture, vitreous puncture and vitreous biopsy followed by pathological cell examination. Cytological examination was immediately performed for all biopsy fluids or tissues; biopsy times, the positive detecting rate and independent pathological diagnosis rate were analyzed. Intraoperative and postoperative complications were observed. Eyeballs with biopsy-suggested malignancy lesions were enucleated and underwent histopathological analysis. The biopsy results and histopathological results were compared and analyzed.Result Thirty-one eyes received 35 times of biopsy operation in total. The available samples harvested from 29 patients through 31 operations were valid for pathological cell examination，the positive detecting rate was 88.6%. Among the 31 eyes, 12 eyes had malignant lesions; 15 eyes had benign lesions; two eyes were diagnosed with benign lesions initially, but corrected to malignant through the second biopsy;the lesions in two eyes were not determined by biopsy. Among the 29 eyes with valid biopsy, 23 eyes were diagnosed independently by pathological examination; the diagnosis of the other six eyes was made based on pathological examination and clinical features. The independent pathological diagnosis rate was 71.4%. The complications included intraocular bleeding in five eyes, retinal detachment in three eyes and more serous inflammation in one eye. The sensitivity for diagnosis of malignant lesions was 85.7% and the specificity was 100.0%. The predictive value of positive test was 100.0% and the negative one was 86.7%.Conclusion Intraocular biopsy has important values in the diagnosis of atypical intraocular lesions.
Purpose To evaluate the correlation of retinal thickness between optical coherence tomography (OCT) images and histologic slides ． Methods Retinal thickness was measured in 16 rabbit retinal histologic slides．The same eyes were previously viewed by OCT for the comparison of results between two methods．Retinal thickness of each OCT image section was measured using both the manually assisted (requiring observer localization of reflectivity peaks) and the automated modes of the computer software． Results Retinal thickness as measured by OCT demonstrated a high degree of correlation with retinal histologic study．The automate d method (gamma;=0．66，P＜0.01) was less reliable than the manually assisted one (gamma;=0．84，P＜0．001)．The former had an error in 95% confidence interval，ranged in-0.71～11.09 mu;m，the latter had a less error，ranged in-2.99～5.13mu;ｍ． Conclusion Retinal thickness can be quantitatively measured by OCT examination．However，computer automatic identification of the reflective boundaries may result in errors in some cases．To measured the retinal thickness by manually assisted mode can increase the degree of accuracy． (Chin J Ocul Fundus Dis，2000，16：71-138)
Objective To compare and evaluate the sensitivity, specificity, accuracy, negative and positive predictive values, negative and positive likelihood ratios of colposcopically directed biopsy and diagnostic cone biopsy in patients with cervical intraepithelial neoplasia. Methods We searched PubMed, CBMdisc, CMCC, CNKI, and VIP to March 2004, and Cochrane Library (Issue 4, 2003). Related journals published from 1970 to 2003 and unpublished papers were hansearched. Diagnostic studies which employed colposcopically directed biopsy or diagnostic cone biopsy and compared with golden standard (pathological diagnosis of specimens obtained through therapeutic conization or hysterectomy) were included and meta-analysis was performed. Participants were clinically suspected of pre-cancerous cervical lesions. Quality of studies was assessed, and SROC curve by Diagnostic and Screening Group of the Cochrane Collaboration was used to perform meta-analysis. Parameters were sensitivity, specificity, accuracy, predictive values, and likelihood ratio. Results Twenty six studies (3 376 patients ranging from 2 to 604 patients/per study) met the inclusion criteria. The quality of studies was generally poor.Before sensitivity analysis, superiority of diagnostic cone biopsy (sensitivity and specificity: 0.83) was shown over colposcopically directed biopsy (sensitivity and specificity: 0.76) (P＜0.001); while after sensitivity analysis the results reversed (sensitivity of diagnostic cone biopsy was 0.58 and its specificity was 0.61; sensitivity and specificity of colposcopically directed biopsy increased to 0.84) (Plt;0.001). Conclusions No definite conclusioncan be drawn as to which method is superior. To make further analysis, more studies with high quality are needed.
【摘要】 目的 探讨CT引导下经椎弓根穿刺活检对椎体病变的诊断价值及可行性。 方法 回顾性分析2009年5月—2010年4月42例椎体病变患者经椎弓根穿刺活检的穿刺活检方法、病理结果、最终诊断及穿刺并发症。 结果 患者总穿刺准确率为95.2%（40/42）。其中恶性病变的穿刺准确率为94.3%（33/35），良性病变穿刺准确率为100%（7/7）；所有患者均未发生严重穿刺并发症。 结论 CT引导下经椎弓根穿刺活检诊断椎体病变有安全可靠、准确性高等特点。【Abstract】 Objective To explore the value and the feasibility of CT guided transpedicular biopsy in diagnosing vertebral body lesions. Methods From May 2009 to April 2010, 42 patients with vertebral body lesions underwent CT guided transpedicular biopsy. The clinical data including the puncture method, pahtological resutls, final diagnosis, and the pucture complications were retrospectively analyzed. Results The total accuracy rate of the puncture was 95.2%(40/42). The accuracy rate of the puncture was 94.3% (33/35) for malignant lesions and 100.0% (7/7) for benign lesions. No complication occurred. Conclusion CT guided transpedicular biopsy is very helpful in diagnosing vertebral body lesions with high accuracy and fewer complications.
ObjectiveTo assess the effect of the size of thyroid nodules on the diagnostic rate of ultrasound guided aspiration cytology (US-FNAB). MethodsThe data of 1 142 (performed by two doctors, 571 each) thyroid nodules between March 2011 and April 2014 in our hospital were retrospectively analyzed. Yields of US-FNAB were divided into two levels of adequacy and inadequacy according to the classification standard of the Bethesda system. The thyroid nodules were classified into five groups according to the largest diameter:≤5 mm group, 5-10 mm group,10-20 mm group, 20-30 mm group, and <30 mm group. According to the grouping of the nodules and the efficiency of US-FNAB drawed curve, the adequacy rates of alone and total of two examiners in each group were analyzed, respectively. ResultsThe adequacy rates of US-FNAB of alone and total of two examiners in≤5 mm group, 5-10 mm group,10-20 mm group, 20-30 mm group, and <30 mm group was 68.42%, 83.72%, 86.08%, 84.62%, and 73.53% (examiner 1); 68.75%, 70.53%, 81.05%, 86.15%, and 73.91% (examiner 2); 68.59%, 77.53%, 83.59%, 85.47%, and 73.75% (total of two examiners), respectively. The total adequacy rate of US-FNAB of two examiners in≤5 mm group was lower than that in 10-20 mm group (P<0.001) and 20-30 mm group (P=0.001). The adequacy rate of US-FNAB of examiner 1 in 5-10 mm group was higher than that examiner 2 (P=0.001). ConclusionsThe size of thyroid nodules significantly influences the adequate diagnostic rate of US-FNAB. The adequacy rates of US-FNAB of the largest diameter≤5 mm or <3mm were lower. The low adequacy rate of US-FNAB may be associated with cystic degeneration in the larger nodules.
ObjectiveTo systematically review the value of the fine-needle biopsies in the diagnosis of benign and malignant breast nodules. MethodsA computer based online search was conducted in PubMed, The Cochrane Library (Issue 7, 2016), EMbase, CBM, CNKI, VIP, WanFang Data databases up to August, 2016 to collect the relevant diagnostic studies of the fine-needle biopsies for benign and malignant breast nodules. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed using Stata 12.0 and Meta-Disc 1.4 software.ResultsA total of 22 studies involving 24 496 patients were finally included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, –LR, and DOR were 0.95 (95%CI 0.95 to 0.96), 0.96 (95%CI 0.96 to 0.96), 38.27 (95%CI 23.17 to 63.19), 0.05 (95%CI 0.03 to 0.07), 1 031.11 (95%CI 514.19 to 2 067.68), respectively. The AUC of SROC was 0.99 (95%CI 0.98 to 1.00).ConclusionThe current evidence indicates that the FNAC has high diagnostic value in the differential diagnosis of benign and malignant breast nodules.