摘要
目的 探讨超声引导肝内结节细针穿刺抽吸活检对AFP阴性亚临床肝癌早期诊断价值.方法 对超声检出肝内≤5 cm结节、血清AFP阴性的患者90例行超声引导下肝内结节穿刺活检,同时行细胞学涂片和组织学切片检查以及临床随访.结果 90例穿刺活检病理诊断为肝细胞癌57例,转移性肝癌14例,良性结节者18例,未定性者1例.肝细胞癌57例中,结节≤2 cm 13例（22.8%）,2～3 cm 37例（64.9%）,3～5 cm 7例（12.3%）.52.6%（30/57）为复发性肝癌,其中6例原发癌术前AFP阳性,19.3%（11/57）在治疗和随访2～18个月后AFP逐渐升高呈阳性;3.5%（2/57）有胃肠道恶性肿瘤手术史.结论 超声引导细针穿刺活检对亚临床肝癌早期诊断、早期治疗以及疗效监测具有重要价值,是AFP阴性患者肝内结节的最佳鉴别诊断方法.
Objective To probe the value of ultrasound guided fine-needle aspiration biopsy in early diagnosis of subclinical hepatic cancer with negative AFP. Methods Ninety cases with negative AFP and hepatic nodules （≤5 cm in diameter on ultrasonography） underwent ultrasound guided fine-needle aspiration biopsy. The specimen were sent for cytology and histology examination after biopsies. All cases were followed up. Results Fifty-seven hepatocellular carcinomas （HCC）, 14 metastasis liver cancer and 18 benign nodules were diagnosed respectively and 1 case was not determined. Fifty- seven HCC included 13 （22.8%） cases with nodules ≤2 cm in diameter, 37 （64.9%） were 2-3 cm, 7 （12.3%） were 3-5 cm. In 30 of 57 （52.6%） cases with recurrent HCC, 6 showed abnormal AFP before surgery. The AFP levels in 11 cases （19.3%） rose gradually after 2-18 months in follow-up. Two of 57 cases （3. 5%） underwent resection of malignant gastrointestinal tumors. Conclusion Ultrasound guided fine-needle aspiration biopsy is highly valuable for the early diagnosis, therapy and curative effect supervision of subclinical hepatic cancer. It provides important cytology evidence in differential diagnosis among intrahepatic nodules with negative AFP.
出处
《中国医学影像技术》
CSCD
北大核心
2006年第9期1395-1398,共4页
Chinese Journal of Medical Imaging Technology
关键词
超声引导
活检
肝肿瘤
甲胎蛋白
Ultrasound guidance
Biopsy
Liver neoplasms
alpha-Fetoproteins
作者简介
何以敉（1958-）,女,福建人,学士,主任医师.研究方向：肝癌早期诊断与介入超声医学.[通讯作者]何以敉,福建医科大学附属协和医院超声科,350001.E-mail： lxdghl@21cn.com
