Core Needle Biopsy (CNB)

芯针活检 (CNB)
  • 文章类型: Journal Article
    这项初步研究旨在使用新型电动驱动的内窥镜超声检查(EUS)引导的17号(G)尺寸芯针活检(CNB)仪器评估上消化道上皮下病变(SEL)的安全性和组织采样。
    研究者主导的前瞻性开放标签,性能和安全控制研究,包括7名患者(女性n=4,中位数71岁,范围28-75),具有确定的SEL(中值尺寸30毫米,上消化道(胃n=6,十二指肠n=1)的范围为17-150mm),随后在索引程序后14天进行了随访。所有研究均根据协议完成,使用四次FNB22-G通过和两次EndoDrill®17-G通过和三次扇动通过。
    与17-GCNB(n=7/7)相比,样品的质量为“可见碎片”(>5mm):FNB(n=5/7)(碎片/血液吸收n=1,组织数量不良n=1)。可以获得最终诊断的组织学结果(平滑肌瘤n=2,腺癌n=1,神经鞘瘤n=1,神经内分泌肿瘤n=1,韧带样肿瘤n=1和胃肠道间质瘤(GIST)n=1)。所有7例患者的17-GCNB仪器。FNB技术在6例患者中达到了正确的诊断。无严重不良事件记录。
    通过使用电动驱动的17-G活检装置,可以在一次穿刺中从感兴趣的区域获得真正的核心组织圆柱体,从而减少对第二次采样的需要。EUS引导的CNB的绝对好处是可以以与标准经皮芯针样品相同的方式处理和组织学制备样品,例如,乳腺癌和前列腺癌.
    UNASSIGNED: This pilot study aimed to evaluate safety and tissue sampling from subepithelial lesions (SEL) in the upper gastrointestinal tract with a novel electric motor driven endoscopic ultrasonography (EUS)-guided 17-gauge (G) size core needle biopsy (CNB) instrument.
    UNASSIGNED: An investigator-led prospective open label, performance and safety control study, including seven patients (female n = 4, median 71 y, range 28-75) with a determined SEL (median size 30 mm, range 17-150 mm) in the upper digestive tract (stomach n = 6, duodenum n = 1) were eligible and later followed up 14 days after index procedure. All investigations were completed according to protocol with three FNB 22-G passes with four fanning strokes and two EndoDrill® 17-G passes with three fanning strokes.
    UNASSIGNED: Quality of samples as \'visible pieces\' (>5 mm): FNB (n = 5/7) (fragmented/blood imbibed n = 1, poor tissue quantity n = 1) compared with 17-G CNB (n = 7/7). Histological result which led to final diagnosis (leiomyoma n = 2, adenocarcinoma n = 1, schwannoma n = 1, neuroendocrine tumour n = 1, desmoid tumour n = 1 and gastrointestinal stromal tumour (GIST) n = 1) could be obtained with the 17-G CNB instrument in all seven patients. FNB technique reached correct diagnosis in six patients. No serious adverse event were recorded.
    UNASSIGNED: By using an electric driven 17-G biopsy device, a true cylinder of core tissue can be obtained in one single puncture from the area of interest reducing the need for a second sampling. The absolute benefit of EUS-guided CNB is that the sample can be handled and histologically prepared in the same manner as standard percutaneous core needle sample, e.g., breast and prostate cancer.
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  • 文章类型: Journal Article
    近年来,由于对个体化和精准医学的追求,肾脏肿块活检(RMB)重新获得了临床兴趣。肾肿块穿刺活检(RMCNB)用于组织病理学(HP),有或没有液基细胞学(LBC),我们医院越来越多地使用。本研究调查了影响RMCNBHP诊断率的因素,并比较单独HP和HP加LBC的诊断率。
    在这项回顾性横断面研究中,在国家癌症中心/国家癌症临床研究中心/肿瘤医院接受超声引导经皮RMCNB治疗的134例患者,2015年1月至2022年5月,中国医学科学院和北京协和医学院入选。所有活检均使用18号芯针活检枪进行,并将18号针槽的取样组织和脱落细胞用于HP和LBC诊断,分别。病人的人口统计,临床适应症,肿瘤特征,活检的数量,最终病理诊断,并对随访数据进行了回顾。进行单变量和多变量逻辑回归分析以评估变量与RMCNB的HP诊断率之间的关联。使用McNemar检验比较HP和HP加LBC的诊断率,并使用Kappa评分评估一致性。
    RMCNB最常见的适应症是肾脏肿块,放射学诊断为局部晚期疾病或远处转移(86.6%)。在88.1%(118/134)的病例中建立了HP诊断率,HP加LBC的诊断率为94.0%(126/134)。Logistic回归分析显示,超过50%的非增强区域[比值比(OR):0.021,95%置信区间(CI):0.003-0.134,P<0.001]和核心活检数量(OR:9.479,95%CI:1.528-58.794,P=0.016)与RCNB的HP诊断率相关。HP加LBC的诊断率明显高于单纯HP(94.0%vs.88.1%,P=0.008),他们表现出基本一致(Kappa=0.638,P<0.001)。同时,在非增强区≥50%亚组,HP加LBC与单纯HP的诊断率有显著差异(86.7%vs.60%,P=0.008),并且协议是公平的(Kappa=0.375,P=0.009)。
    RMCNB具有较高的诊断率,至少需要两次高质量的核心活检,LBC可以单独提高HP的诊断率,特别是在大的非增强面积的群众。
    UNASSIGNED: Renal mass biopsy (RMB) has regained clinical interest in recent years due to the pursuit of individualized and precision medicine. Renal mass core needle biopsy (RMCNB) for histopathology (HP), with or without liquid-based cytology (LBC), has been used increasingly in our hospital. This study investigated factors influencing the HP diagnostic yield of RMCNB, and compared the diagnostic rate between HP alone and HP plus LBC.
    UNASSIGNED: In this retrospective cross-sectional study, a total of 134 patients who underwent ultrasound-guided percutaneous RMCNB in the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2015 and May 2022 were enrolled. All biopsies were performed using an 18-gauge core needle biopsy gun, and the sampling tissues and exfoliative cells of 18-gauge core needle groove were delivered for HP and LBC diagnosis, respectively. The patient demographics, clinical indications, tumor characteristics, number of biopsies, final pathological diagnosis, and follow-up data were reviewed. Univariate and multivariate logistic regression analyses were performed to evaluate the association between variables and HP diagnostic yield of RMCNB. The diagnostic rate between HP and HP plus LBC was compared using McNemar\'s test and agreement was evaluated using the Kappa score.
    UNASSIGNED: The most common indication of RMCNB was renal masses with a radiological diagnosis of locally advanced disease or distant metastasis (86.6%). The HP diagnostic yield was established in 88.1% (118/134) of cases, and the diagnostic rate of HP plus LBC was 94.0% (126/134). Logistic regression analyses revealed that non-enhanced area exceeding 50% [odds ratio (OR): 0.021, 95% confidence interval (CI): 0.003-0.134, P<0.001] and number of core biopsies (OR: 9.479, 95% CI: 1.528-58.794, P=0.016) were associated with the HP diagnostic yield of RMCNB. The diagnostic rate of HP plus LBC was significantly higher than that of HP alone (94.0% vs. 88.1%, P=0.008), and they showed substantial agreement (Kappa =0.638, P<0.001). Meanwhile, in the non-enhanced area ≥50% subgroup, the diagnostic rate between HP plus LBC and HP alone was significantly different (86.7% vs. 60%, P=0.008), and the agreement was fair (Kappa =0.375, P=0.009).
    UNASSIGNED: RMCNB has a high diagnostic yield with a minimum of two high-quality core biopsies, LBC can improve the diagnostic yield of HP alone, especially in masses with large non-enhanced area.
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  • 文章类型: Journal Article
    背景与目的大多数乳腺疾病表现为可触及的肿块。结合临床检查可提高其诊断的准确性,乳房X线照相术,细针穿刺细胞学(FNAC),术前进行芯针活检(CNB)。乳腺肿块的FNAC或CNB的最终目的是在术前确认癌症的诊断,这可能有助于避免良性疾病的不必要手术。组织病理学是建立乳腺肿块诊断的金标准。在这项研究中,我们的目的是比较灵敏度,特异性,阳性预测值(PPV),负预测值(NPV),FNAC与Trucut活检的诊断准确性,并提供FNAC和CNB对可疑乳腺恶性肿瘤切除乳腺肿块的最终组织病理学诊断的联合评估。材料和方法这是一个前瞻性的,观察,为期一年的横断面研究,涉及42例疑似乳腺癌患者接受FNAC,CNB,手术切除后进行组织病理学检查。收集数据,并在灵敏度方面进行分析,特异性,PPV,NPV,与组织病理学相比,FNAC和CNB的诊断准确性。结果研究中的大多数患者(78.6%)年龄在31-50岁之间。在我们的研究中,FNAC表现出敏感性,特异性,PPV,NPV,诊断准确率为74.1%,76.9%,87.0%,64.7%,分别为75%。CNB有一种敏感性,特异性,PPV,NPV,诊断准确率为85.2%,92.8%,95.8%,76.5%,分别为87.8%。两种模式(FNAC和CNB)之间的一致性水平中等且具有统计学意义(k=0.543;p<0.001)。在FNAC和CNB针对恶性肿瘤/临界诊断的最终组织病理学诊断的联合评估中,灵敏度,特异性,PPV,NPV,诊断准确率为89.3%,85.7%,92.6%,80%,分别为88.1%。结论FNAC和CNB联合评估对恶性肿瘤/临界诊断的最终组织病理学诊断的诊断准确性优于FNAC或CNB。这一发现表明,这两种技术是相辅相成的。FNAC和CNB分别作为病理诊断的一线和二线方法。
    Background and objective Most breast diseases present as palpable lumps. The accuracy of their diagnosis can be enhanced by a combination of clinical examination, mammography, fine-needle aspiration cytology (FNAC), and core needle biopsy (CNB) preoperatively. The ultimate aim of FNAC or CNB of the breast mass is to confirm the diagnosis of cancer preoperatively, which may help avoid unnecessary surgeries for benign conditions. Histopathology is the gold standard to establish the diagnosis of a breast mass. In this study, we aimed to compare the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of FNAC with those of trucut biopsy, and provide a combined assessment of FNAC and CNB against the final histopathological diagnosis of excised breast mass in suspected breast malignancies. Materials and methods This was a prospective, observational, cross-sectional study conducted for a duration of one year involving 42 patients with suspected breast cancer cases who underwent FNAC, CNB, and surgical excision followed by a histopathological examination. Data were collected and analyzed in terms of sensitivity, specificity, PPV, NPV, and diagnostic accuracy of FNAC and CNB in comparison with histopathology. Results The majority of the patients in the study (78.6%) were in the age group of 31-50 years. In our study, FNAC showed a sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 74.1%, 76.9%, 87.0%, 64.7%, and 75% respectively. CNB had a sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 85.2%, 92.8%, 95.8%, 76.5%, and 87.8% respectively. The level of agreement between the two modalities (FNAC and CNB) was moderate and statistically significant (k=0.543; p<0.001). In the combined assessment of FNAC and CNB against final histopathological diagnosis for malignancy/borderline diagnosis, the sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 89.3%, 85.7%, 92.6%, 80%, and 88.1% respectively. Conclusion The diagnostic accuracy of the combined assessment of FNAC and CNB against final histopathological diagnosis for malignancy/borderline diagnosis was better than that of FNAC or CNB alone. This finding shows that both the techniques complement each other. FNAC and CNB are used as the first- and second-line methods of pathological diagnosis respectively.
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  • 文章类型: Journal Article
    超声(US)引导下的粗针活检(CNB)广泛应用于乳腺癌可疑腋窝淋巴结(ALN)的病理诊断。然而,活检期间切除的标本数量目前基于个体放射科医师的偏好.本研究旨在分析乳腺癌中可疑ALN的美国指导CNB的基于样本数的诊断产量。
    可疑淋巴结的核心活检标本是在11月之间从我们医院接受治疗的乳腺癌患者中获得的,2018年7月,2019.从每个患者获得四个样本,并按照它们被移除的顺序标记为1-4。对每个标本进行病理评估以确定是否发生了转移。计算样本的诊断率,并通过McNemar检验评估根据样本数量的诊断准确性差异。
    共纳入167名患者,CNB确定转移139例(83.2%)。诊断率为:74.2%(样本1),87.8%(试样1-2),91.2%(试样1-3),和94.6%(标本1-4)。从标本1到1-2和从标本1-2到1-4的诊断产量的增加是显著的;然而,在标本1-3和前两个之间没有检测到显著差异,或在样本1-4和前三个之间。前两个标本的较低诊断能力与US上淋巴结的长轴和短轴长度有关。
    尽管在乳腺癌的核心活检中,第二个标本对可疑腋窝淋巴结的诊断率有重要贡献,本研究无法确定最小数量。额外的标本可以提高诊断率,特别是在小结节患者中。
    UNASSIGNED: Ultrasound (US)-guided core needle biopsy (CNB) is widely applied in the pathological diagnosis of suspicious axillary lymph nodes (ALNs) in breast cancer. However, the number of specimens removed during biopsy is currently based on the preference of the individual radiologist. This study aims to analyze the specimen number based diagnostic yields of US guided CNB of suspicious ALNs in breast cancer.
    UNASSIGNED: Core biopsy specimens of suspicious lymph nodes were prospectively obtained from breast cancer patients treated at our hospital between November, 2018, and July, 2019. Four specimens were obtained from each patient and labeled 1-4 in the order they were removed. Each specimen underwent pathological evaluation to determine whether metastasis had occurred. The diagnostic yields of the specimens were calculated and differences in diagnostic accuracy according to the number of specimens were evaluated by McNemar\'s test.
    UNASSIGNED: A total of 167 patients were enrolled, and 139 (83.2%) cases were identified as metastasis by CNB. The diagnostic yields were: 74.2% (specimen 1), 87.8% (specimens 1-2), 91.2% (specimens 1-3), and 94.6% (specimens 1-4). The increases in diagnostic yield from specimen 1 to 1-2 and from specimens 1-2 to 1-4 were significant; however, no significant differences were detected between specimens 1-3 and the first two, or between specimens 1-4 and the first three in this sample size. The lower diagnostic abilities for the first two specimens were associated with shorter long- and short-axis lengths of lymph nodes on US.
    UNASSIGNED: Although the second specimen contributed significant diagnostic yield of suspicious axillary lymph nodes in core biopsy in breast cancer, a minimum number cannot be determined by this study. Additional specimens may improve diagnostic yield particularly in patients with small nodes.
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