Amniocentesis is an essential tool in obstetrics. Invasive testing remains the only modality for diagnostic genetic testing and the only way to provide comprehensive test-ing for chromosomal abnormalities. Despite inc...Amniocentesis is an essential tool in obstetrics. Invasive testing remains the only modality for diagnostic genetic testing and the only way to provide comprehensive test-ing for chromosomal abnormalities. Despite increasing use of cell free fetal deoxyribonucleic acid （DNA） testing, amniocentesis should still be offered to all women who desire more complete and accurate genetic testing. Counseling patients on the limitations of screening tests is of the upmost importance and amniocentesis should continue to be recommended to confrm positive results from cell free fetal DNA testing or in the case of failed cell free fetal DNA test. As cell free fetal DNA screening has not adequately been studied in multiple gestations, its use is not recommended in this population and invasive testing should be offered. Amniocentesis is also very useful in providing additional information in settings other than genetic testing the second and third trimester. If intraamniotic infection is suspected, but the clinical fndings are not enough to guide manage-ment, amniocentesis can provide testing that can both immediately clarify the picture （interleukin-6, gram stain, glucose levels） and finally confirm the presence of infection （culture）. It can also be used to detect the presence of intrauterine viral infections. Additionally, amniocentesis may be used to test for markers of fetal lung maturity. The American Congress of Obstetricians and Gynecologists recommends that amniocentesis for this indication not be used in cases where late preterm delivery is indicated. It may be useful in guiding decision-making, however , when late preterm delivery is indicated, but when exact timing is unclear. Regardless of the indication, amniocentesis appears to be a relatively low risk procedure with minimal risk to the patient. Additional randomized controlled trials are not likely, as they are not feasible to due extremely high number of participants that would be needed to detect a difference in loss rates. Based on current literature, however, the risk of pregnancy loss from second trime-ster amniocentesis is low in both singleton and twin gestations. We counsel patients that technique has changed since the original studies in the 1970s and feel comfortable quoting a loss rate of 1/500-1/1000 based on contemporary data.展开更多
This article reported that 2 cases with skin singular leiomyoma confirmed by pathology were misdiagnosed by fine needle aspiration biopsy, and the combination analysis of clinical history and pathological features of ...This article reported that 2 cases with skin singular leiomyoma confirmed by pathology were misdiagnosed by fine needle aspiration biopsy, and the combination analysis of clinical history and pathological features of cells was as follows.展开更多
OBJECTIVE To evaluate core needle biopsy (CNB) as a mini-mally invasive method to examine breast lesions and discuss theclinical significance of subsequent immunohistochemistry (IHC)analysis.METHODS The clinical data ...OBJECTIVE To evaluate core needle biopsy (CNB) as a mini-mally invasive method to examine breast lesions and discuss theclinical significance of subsequent immunohistochemistry (IHC)analysis.METHODS The clinical data and pathological results of 235 pa-tients with breast lesions, who received CNB before surgery, wereanalyzed and compared. Based on the results of CNB done beforesurgery, 87 out of 204 patients diagnosed as invasive carcinomawere subjected to immunodetection for p53, c-erbB-2, ER and PR.The morphological change of cancer tissues in response to chemo-therapy was also evaluated.RESULTS In total of 235 cases receiving CNB examination, 204were diagnosed as invasive carcinoma, reaching a 100% consistentrate with the surgical diagnosis. Sixty percent of the cases diag-nosed as non-invasive carcinoma by CNB was identified to havethe presence of invading elements in surgical specimens, and simi-larly, 50% of the cases diagnosed as atypical ductal hyperplasia byCNB was confirmed to be carcinoma by the subsequent result ofexcision biopsy. There was no significant difference between theCNB biopsy and regular surgical samples in positive rate of im-munohistochemistry analysis (p53, c-erbB-2, ER and PR; P >0.05).However, there was significant difference in the expression rate ofp53 and c-erbB-2 between the cases with and without morphologi-cal change in response to chemotherapy (P < 0.05). In most caseswith p53 and c-erbB-2 positive, there was no obvious morphologi-cal change after chemotherapy.CONCLUSION CNB is a cost-effective diagnostic method withminimal invasion for breast lesions, although it still has some limi-tations. Immunodetection on CNB tissue is expected to have greatsignificance in clinical applications.展开更多
文摘Amniocentesis is an essential tool in obstetrics. Invasive testing remains the only modality for diagnostic genetic testing and the only way to provide comprehensive test-ing for chromosomal abnormalities. Despite increasing use of cell free fetal deoxyribonucleic acid （DNA） testing, amniocentesis should still be offered to all women who desire more complete and accurate genetic testing. Counseling patients on the limitations of screening tests is of the upmost importance and amniocentesis should continue to be recommended to confrm positive results from cell free fetal DNA testing or in the case of failed cell free fetal DNA test. As cell free fetal DNA screening has not adequately been studied in multiple gestations, its use is not recommended in this population and invasive testing should be offered. Amniocentesis is also very useful in providing additional information in settings other than genetic testing the second and third trimester. If intraamniotic infection is suspected, but the clinical fndings are not enough to guide manage-ment, amniocentesis can provide testing that can both immediately clarify the picture （interleukin-6, gram stain, glucose levels） and finally confirm the presence of infection （culture）. It can also be used to detect the presence of intrauterine viral infections. Additionally, amniocentesis may be used to test for markers of fetal lung maturity. The American Congress of Obstetricians and Gynecologists recommends that amniocentesis for this indication not be used in cases where late preterm delivery is indicated. It may be useful in guiding decision-making, however , when late preterm delivery is indicated, but when exact timing is unclear. Regardless of the indication, amniocentesis appears to be a relatively low risk procedure with minimal risk to the patient. Additional randomized controlled trials are not likely, as they are not feasible to due extremely high number of participants that would be needed to detect a difference in loss rates. Based on current literature, however, the risk of pregnancy loss from second trime-ster amniocentesis is low in both singleton and twin gestations. We counsel patients that technique has changed since the original studies in the 1970s and feel comfortable quoting a loss rate of 1/500-1/1000 based on contemporary data.
文摘This article reported that 2 cases with skin singular leiomyoma confirmed by pathology were misdiagnosed by fine needle aspiration biopsy, and the combination analysis of clinical history and pathological features of cells was as follows.
文摘OBJECTIVE To evaluate core needle biopsy (CNB) as a mini-mally invasive method to examine breast lesions and discuss theclinical significance of subsequent immunohistochemistry (IHC)analysis.METHODS The clinical data and pathological results of 235 pa-tients with breast lesions, who received CNB before surgery, wereanalyzed and compared. Based on the results of CNB done beforesurgery, 87 out of 204 patients diagnosed as invasive carcinomawere subjected to immunodetection for p53, c-erbB-2, ER and PR.The morphological change of cancer tissues in response to chemo-therapy was also evaluated.RESULTS In total of 235 cases receiving CNB examination, 204were diagnosed as invasive carcinoma, reaching a 100% consistentrate with the surgical diagnosis. Sixty percent of the cases diag-nosed as non-invasive carcinoma by CNB was identified to havethe presence of invading elements in surgical specimens, and simi-larly, 50% of the cases diagnosed as atypical ductal hyperplasia byCNB was confirmed to be carcinoma by the subsequent result ofexcision biopsy. There was no significant difference between theCNB biopsy and regular surgical samples in positive rate of im-munohistochemistry analysis (p53, c-erbB-2, ER and PR; P >0.05).However, there was significant difference in the expression rate ofp53 and c-erbB-2 between the cases with and without morphologi-cal change in response to chemotherapy (P < 0.05). In most caseswith p53 and c-erbB-2 positive, there was no obvious morphologi-cal change after chemotherapy.CONCLUSION CNB is a cost-effective diagnostic method withminimal invasion for breast lesions, although it still has some limi-tations. Immunodetection on CNB tissue is expected to have greatsignificance in clinical applications.
