세침흡인검사로 진단되지 않은 종괴에 대해 두경부 외과의가 시행한초음파 유도 하 중심바늘생검의 진단적 유용성
Diagnostic Utility of Ultrasound-Guided Core-Needle Biopsy Performed by a Head and Neck Surgeon for Mass Lesions with Inconclusive Result in Fine-Needle Aspiration Cytology
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Background and Objectives To evaluate the diagnostic utility of ultrasound (US)-guided core-needle biopsy (CNB) (US-CNB) performed by a head and neck surgeon for mass lesions with inconclusive result in previous fine-needle aspiration cytology (FNAC). Subjects and Method Forty six patients who had previously inconclusive results of non-diagnostic specimen, undetermined significance, and malignancy/suspicious malignancy with undetermined subtype were included in the study. They were divided into the repeating FNAC (rFNAC) group and CNB groups. Procedure time, success of targeting, and complications were evaluated in the CNB group. In addition, the diagnostic utility of CNB was compared with that of FNAC. Results US-CNB was successfully completed by a head and neck surgeon in all 23 cases without any major complications. The US-CNB group showed significantly lower rates of repeated non-diagnostic/undetermined results than in the rFNAC group (0% vs. 40.9%, p=0.001). In addition, CNB provided specific pathological diagnoses that permitted the surgeon to establish an appropriate treatment plan in 95.7% (22/23) of the CNB group, while rFNAC provided specific pathological diagnoses in 56.5% (13/23) of the rFNAC group (p=0.002). Conclusion US-CNB can be performed safely by head and neck surgeons, providing better diagnostic results compared with those of rFNAC for mass lesions with inconclusive results in previous FNAC. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(4):293-9
Abstract
Background and Objectives To evaluate the diagnostic utility of ultrasound (US)-guided core-needle biopsy (CNB) (US-CNB) performed by a head and neck surgeon for mass lesions with inconclusive result in previous fine-needle aspiration cytology (FNAC). Subjects and Method Forty six patients who had previously inconclusive results of non-diagnostic specimen, undetermined significance, and malignancy/suspicious malignancy with undetermined subtype were included in the study. They were divided into the repeating FNAC (rFNAC) group and CNB groups. Procedure time, success of targeting, and complications were evaluated in the CNB group. In addition, the diagnostic utility of CNB was compared with that of FNAC. Results US-CNB was successfully completed by a head and neck surgeon in all 23 cases without any major complications. The US-CNB group showed significantly lower rates of repeated non-diagnostic/undetermined results than in the rFNAC group (0% vs. 40.9%, p=0.001). In addition, CNB provided specific pathological diagnoses that permitted the surgeon to establish an appropriate treatment plan in 95.7% (22/23) of the CNB group, while rFNAC provided specific pathological diagnoses in 56.5% (13/23) of the rFNAC group (p=0.002). Conclusion US-CNB can be performed safely by head and neck surgeons, providing better diagnostic results compared with those of rFNAC for mass lesions with inconclusive results in previous FNAC. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(4):293-9
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