■在丹麦,细针抽吸是从颈部淋巴结(LN)获取组织样本的标准化工具。然而,因为对淋巴瘤的特异性低,怀疑这种疾病的LN通常通过手术切除和检查。国际研究表明,芯针活检(CNB)足以检测淋巴瘤,从而有可能避免手术。然而,所有研究都是回顾性研究,这项前瞻性研究的目的是发现CNB的真正敏感性.
■57名患者被纳入研究,由于缺乏CNB材料而被排除在外。怀疑淋巴瘤的LN被手术从颈部切除,此后,从除去的LN获得CNB。CNB和LN的剩余部分被送到病理学部门进行进一步处理,并且样品被致盲并分别由两名病理学家检查。在诊断建议不同的情况下,达成了共识诊断。计算了CNB方法与整个组织切片相比用于淋巴瘤诊断的敏感性。
■CNB方法在66%的淋巴瘤病例中给出了正确的诊断,14%的患者没有定论,18%的患者给出了不正确的淋巴瘤亚型。2%的CNB错误地导致良性诊断。CNB在所有非淋巴瘤病例中是正确的;从而保持100%的特异性。
■这项前瞻性研究发现,用CNB诊断淋巴瘤的敏感性为66%。由于本研究中的CNB是在最佳条件下获得的,与临床实践不同,我们得出的结论是,CNB不能被推荐作为诊断淋巴瘤的标准工具。
UNASSIGNED: In Denmark, fine needle aspiration is the standardized tool for obtaining tissue samples from lymph nodes (LN) of the neck. However, because of a low specificity toward lymphomas, LNs suspicious for this disease are often surgically removed and examined. International studies have implied that a core needle biopsy (CNB) is sufficient for detecting lymphomas, thereby potentially avoiding surgery. However, all studies have been conducted retrospectively and the goal of this prospective study was to find the true sensitivity of CNB.
UNASSIGNED: Fifty-seven patients were enrolled in the study, one was excluded due to lack of CNB material. LNs suspected for lymphoma were surgically removed from the neck, whereafter a CNB was obtained from the removed LN. The CNB and the remaining part of the LN were sent to the Department of Pathology for further processing and the samples were blinded and examined by two pathologists separately. A consensus diagnosis was reached in cases with divergent diagnostic proposals. Sensitivity of the CNB method in comparison to whole tissue sections for lymphoma diagnosis was calculated.
UNASSIGNED: The CNB method gave the correct diagnosis in 66% of lymphoma cases, was inconclusive in 14% and gave an incorrect lymphoma subtype in 18%. In 2% the CNB wrongly resulted in a benign diagnosis. CNB was correct in all the non-lymphoma cases; thereby retaining a specificity of 100%.
UNASSIGNED: This prospective study found a sensitivity of 66% for diagnosing lymphoma with a CNB. As the CNB in this study was obtained under optimal conditions, unlike in clinical practice, we conclude that CNB cannot be recommended as a standard tool for diagnosing lymphomas.