Conclusive diagnosis of hepatic and pancreatic malignancies by fine needle aspiration.
Conclusive diagnosis of hepatic and pancreatic malignancies by fine needle aspiration.
复制标题
通过细针抽吸对肝脏和胰腺恶性肿瘤进行最终诊断。
作者：
S. Pilotti;F. Rilke;R. Claren;M. Milella;L. Lombardi
本文报告了209例经病理或临床证实的肝、胰恶性肿瘤患者的221例穿刺标本，其中肝病变159例，胰病变50例。FNA阳性结果的敏感性、特异性和预测性值分别为：肝脏0.84、0.96和1.0，胰腺0.76、1.0和1.0。病例材料的组成显示，肝脏和胰腺恶性肿瘤的发生率分别为84%和60%（其中原发性恶性肿瘤分别为39%和48%），而非肿瘤性病变的发生率分别为14%和40%。然而，在60%的肝脏病变中，FNA对原发肿瘤的组织学类型和转移性肿瘤的起源部位作出了结论性诊断，但仅9%的胰腺病变作出了结论性诊断。在95%的病例中，FNA诊断原发性肝细胞癌; FNA特异性诊断42%的肝内胆管癌和40%的肝转移。这些发现与肝内原发性肝细胞癌的独特细胞学特征相关，而与肝内和肝外起源的癌以及胰腺导管起源的癌的非特异性形态相关。
A study of the diagnosis of hepatic and pancreatic malignancies by fine needle aspiration (FNA) was made, based on 221 aspirates obtained from 209 patients with histologic or clinical confirmation: 159 with hepatic and 50 with pancreatic lesions. The values of sensitivity, specificity and predictivity for positive FNA results were, respectively, 0.84, 0.96 and 1.0 for the liver and 0.76, 1.0 and 1.0 for the pancreas. The composition of the case material showed an incidence of malignant tumors of the liver and pancreas of 84% and 60%, respectively (among which the primary malignancies were 39% and 48%), while nonneoplastic lesions had incidences of 14% and 40%. However, conclusive FNA diagnoses of the histologic type of the primary and the site of origin of metastatic tumors were made in 60% of the hepatic lesions but in only 9% of the pancreatic lesions. Primary hepatocellular carcinoma was diagnosed by FNA of the liver in 95% of the cases; FNA specifically diagnosed 42% of intrahepatic bile duct carcinomas and 40% of hepatic metastases. These findings correlate with the unique cytologic features of primary hepatocellular carcinoma of intrahepatic rather nonspecific morphology of carcinoma of intrahepatic and extrahepatic origin, as well as of pancreatic ductal origin.