超声引导下穿刺活检对小肝癌早期诊断的应用价值

Evaluation of transrectal ultrasound guided biopsies in the early diagnosis of small hepatocellular carcinoma

目的:探讨超声引导下经皮穿刺组织学活检对小肝癌的临床早期诊断价值。方法:对60例经影像学检查发现的直径小于3 cm的60个肝内实质性结节施行超声引导下穿刺活检,行组织病理学检查。结果:60个结节156次取材全部成功,病理确诊率达96.7%,无明显并发症发生。原发性肝细胞肝癌25个(41.7%),毛细胆管癌3个(5%),转移癌4个(6.7%),肝硬化结节6个(10%),肝炎性结节5个(8.3%),局灶性脂肪肝7个(11.1%),肝血管瘤6个(10%),肝结核2个(3.3%),病理阴性2个(3.3%),经手术证实分别为小肝癌和肝硬化结节。结论:超声引导下经皮穿刺组织学活检以其微创、快捷、并发症少及确诊率高等优势对小肝癌的临床早期诊断具有重要价值。

Objective To evaluate the value of transrectal ultrasound guided biopsies in the early diagnosis of small hepatocellular carcinoma.Method The hepatic solid lesions whose diameters were shorter than 3cm found in 60 patients through imageology examination were carried out by the percutaneous puncture biopsy under ultrasonic guidance.Results 165 times of puncturations on 60 cases were all succeeded without complication.The final pathological diagnosis rate reached 96.7%.Hepatic cell carcinoma in 25 cases,cholangiole carcinoma in 3 cases,metastatic carcinoma in 4 cases,liver cirrhosis nodus in 6 cases,hepatitis nodus in 5 cases,focal adiposis hepatica in 7 cases,hemangiomas of liver in 6 cases,hepatic phthisis in 2 cases,negative result in 2 cases（one was small liver carcinoma,the other was liver cirrhosis nodus）.Conclusion Puncture biopsy under ultrasonic guidance to the hepatic small lesions possesses important significance on finding out the quality of the lump and making the early diagnosis of malignant tumors,and it has the merits of the less wound,quick ness,less complications and high final diagnosis rate.