ABSTRACT
Objective To investigate the diagnostic value of improved pleural biopsy combined with biomarker and cytology detection in pleural effusion of unknown origin.Methods The clinical data in 216 cases of pleural effusion were respectively analyzed including 106 cases of tuberculous pleural effusion(tuberculosis group) and 110 cases of malignant pleural effusion(malignant group).All cases were performed the improved pleural biopsy,cytology examination and detection of pleural effusion ADA,CEA and LDH,and serum CEA.The pleural biopsy diagnosis rate was performed the statistics,and pleural effusion ADA,CEA and LDH,serum CEA,and pleural effusion CEA/serum CEA were compared between the two groups.Results Among 216 cases,241 times of pleural biopsy puncture were conducted,the first time puncture success rate was 94.9 ％ (205/216).Having the diagnostic value among pathological results of pleural biopsy materials in first puncture success accounted for 58.8％ (127/216),and the overall diagnosis rate was 65.3 ％ (141/216).The incidence rate of adverse reactions was 5.8 ％ (14/241).In the tuberculosis group,no case showed cytology tumor cell positive,while the cytology tumor cell positive rate in the malignant group was 54.5％ (60/110);pleural effusion CEA and LDH,serum CEA and pleural effusion CEA / serum CEA levels and positive rates in the malignant group were significantly higher than those in the tuberculosis group,while the pleural effusion ADA level and positive rate were significantly lower than those in the tuberculosis group the difference was statistically significant(P＜0.01).Conclusion Improved pleural biopsy,pleural effusion cytology,pleural effusion biomarkers have a certain limitation in alone auxiliary diagnosis of pleural effusion.The various indicators can be combined to determine the etiology of pleural effusion in clinic for guiding treatment.
ABSTRACT
ObjectiveTo evaluate the diagnostic value of ultrasound or CT guided percutaneous Trucut needle biopsy on the diagnosis of pancreatic tumors.Methods One hundred and twenty-four patients clinically diagnosed as pancreatic cancer without pathological diagnosis underwent percutaneous pancreatic biopsy by using Trucut needle under ultrasound or CT guidance.ResultsOne hundred and nine procedures of ultrasound-guided biopsy and 15 procedures of CT-guided biopsy were performed,and one patient received 2.3times of punctures.Tissue samples were obtained in all 124 patients,the diagnostic accuracy was 95.2％,among them 115 were adenocarcinoma,5 were cystadenoma,2 were metastasis cancer,1 was cancer of unknown origin and 1 was normal.The sensitivity,specificity,and accuracy were 99.2％ 100％,and 99.2％,respectively.Transient serum amylase increase was observed in 3 patients; 5 patients' abdominal pain aggravated,but all recovered with conservative management.One patient was found to have tumor seeding on the spot of insertion after 34 days.No other major complications occurred.ConclusionsUltrasound or CTguided percutaneous pancreatic 16 ～ 18G Trucut needle biopsy is a safe and simple procedure with excellent diagnostic value for pancreatic cancer.