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Diagnostic efficacy and molecular testing by combined fine needle aspiration and core needle biopsy in patients with a lung nodule.

肺结节患者细针穿刺联合芯针活检的诊断效能和分子检测。

  • 影响因子:3.49
  • DOI:10.1002/cncy.22234
  • 作者列表:"Chen L","Jing H","Gong Y","Tam AL","Stewart J","Staerkel G","Guo M
  • 发表时间:2020-01-08
Abstract

BACKGROUND:Combined image-guided fine needle aspiration biopsy (FNA) and core needle biopsy (CNB) has become the standard of care for diagnosis and/or molecular testing for patients with a solitary lung nodule at our institution. Our purpose was to evaluate the efficacy of this practice. METHODS:We identified patients who underwent combined lung FNA/CNB during 2012 at our institution. A total of 667 patients who underwent 682 combined lung FNA/CNB procedures were included in the study, including 355 men and 312 women. Combined lung FNA/CNB procedures were performed by a radiologist. The adequacy of FNA specimens was assessed immediately by a cytopathologist. The FNA and CNB specimens were interpreted separately by a cytopathologist and a surgical pathologist, respectively. The diagnostic accuracy of the combined technique was determined. RESULTS:The rate of diagnostic consistency between FNA and CNB was 83.4%, and the rate of diagnostic accuracy for malignancy was 98.5% for combined FNA/CNB. Combined FNA/CNB showed a high diagnostic efficacy for malignancy (sensitivity, 97.6%; specificity, 100%). Combined FNA/CNB had a lower false-negative rate for malignancy (2.2%) than either FNA (7.2%) or CNB (6.2%) alone. FNA contributed to 10.3% of molecular analyses as a complementary tissue source. CONCLUSIONS:Combined lung FNA/CNB has high diagnostic efficacy for malignancy and a lower false-negative rate than either procedure alone. FNA was a valuable complement to CNB for molecular testing, potentially reducing patient inconvenience and morbidity associated with repeated lung needle biopsy.

摘要

背景: 影像引导下细针穿刺活检 (FNA) 和粗针穿刺活检 (CNB) 联合已成为我们机构孤立性肺结节患者诊断和/或分子检测的标准护理。我们的目的是评估这种做法的疗效。 方法: 我们确定了 2012年在我们机构接受联合肺 FNA/CNB 的患者。共有 667 例接受 682 次联合肺 FNA/CNB 手术的患者纳入研究,其中男性 355 例,女性 312 例。由放射科医师进行联合肺 FNA/CNB 手术。细胞病理学家立即评估 FNA 标本的充分性。FNA 和 CNB 标本分别由细胞病理学家和外科病理学家解释。确定了联合技术的诊断准确性。 结果: FNA 与 CNB 的诊断符合率为 83.4%,联合 FNA/CNB 对恶性肿瘤的诊断符合率为 98.5%。联合 FNA/CNB 对恶性肿瘤显示出较高的诊断效能 (敏感性,97.6%; 特异性,100%)。联合 FNA/CNB 对恶性肿瘤的假阴性率 (2.2%) 低于单独 FNA (7.2%) 或 CNB (6.2%)。FNA 作为互补组织来源贡献了 10.3% 的分子分析。 结论: 联合肺 FNA/CNB 对恶性肿瘤的诊断效能高,假阴性率低于单独任何一种手术。FNA 是 CNB 分子检测的有价值的补充,可能减少患者不便和重复肺穿刺活检相关的发病率。

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