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ARCH PATHOL LAB MED：将不典型小叶增生与原位小叶癌经皮穿刺活检术进行手术或观察

2019-05-09 不详 网络

原位小叶癌
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从强制性的外科切除到临床/影像学观察，对于在核心活组织检查中发现的小叶瘤形成（LN）的管理目前尚存在争议。研究人员对正常和病变的终末管小叶单位(TDLUs)进行量化，以评估是否可以预测哪些病例需要手术切除，哪些可以安全随访。第二个目标是评估核心活检结果的一致性或不一致性（由严格的放射学-病理学相关性决定）能否预测在切除时升级为恶性肿瘤。

从强制性的外科切除到临床/影像学观察，对于在核心活组织检查中发现的小叶瘤形成（LN）的管理目前尚存在争议。研究人员对正常和病变的终末管小叶单位(TDLUs)进行量化，以评估是否可以预测哪些病例需要手术切除，哪些可以安全随访。第二个目标是评估核心活检结果的一致性或不一致性（由严格的放射学-病理学相关性决定）能否预测在切除时升级为恶性肿瘤。

在这一回顾性研究中，研究人员对2005年至2012年间78例接受图像引导下核心针活检产生LN的妇女的79例标本进行了TDLUs总数量和LN累及TDLUs的总数量和百分比的评估。此外，放射学-病理学的相关性进行评估一致性或不一致性。所有结果均与手术切除活检或影像学/临床随访结果相关。

研究显示有5个升级为恶性肿瘤。评估的3个TDLU变量中，包括样本中的TDLUs总量(P = .42)、TDLUs总量异常(P = .56)和TDLUs异常百分比(P = .07)与肿瘤升级为恶性之间没有相关性。Kendall等级相关性证明了手术中不一致和癌症升级之间的相关性具有统计学意义（τb= -0.394，P <.001）。

研究表明对所有TDLU和LN在核心活检中涉及的TDLU进行量化，对患者进行手术或观察没有实际意义。通过密切的放射病理相关性来确定病变的一致性/不一致性，可以预测哪些患者将从手术切除中获益。

原始出处：

Anna I. Holbrook, MD; Krisztina Hanley, MD;Triaging Atypical Lobular Hyperplasia and Lobular Carcinoma In Situ on Percutaneous Core Biopsy to Surgery or Observation: Assiduous Radiologic-Pathologic Correlation Works, Quantitating Extent of Disease Does Not

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    2020-03-10 yb6560

    #Pathol#

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    2019-10-29 yangfl06

    #穿刺活检#

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    2019-12-23 Boyinsh

    #经皮穿刺#

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    2019-10-28 yaanren

    #不典型#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1786280, encodeId=8a8c1e862803d, content=<a href='/topic/show?id=569f13e9045' target=_blank style='color:#2F92EE;'>#Pathol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13790, encryptionId=569f13e9045, topicName=Pathol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Tue Mar 10 06:12:00 CST 2020, time=2020-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005303, encodeId=1c35200530371, content=<a href='/topic/show?id=0f4de5432ce' target=_blank style='color:#2F92EE;'>#穿刺活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75432, encryptionId=0f4de5432ce, topicName=穿刺活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1c2e485, createdName=yangfl06, createdTime=Tue Oct 29 11:12:00 CST 2019, time=2019-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2023245, encodeId=85bc202324507, content=<a href='/topic/show?id=edd6e842119' target=_blank style='color:#2F92EE;'>#经皮穿刺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78421, encryptionId=edd6e842119, topicName=经皮穿刺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Mon Dec 23 20:12:00 CST 2019, time=2019-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898649, encodeId=03321898649aa, content=<a href='/topic/show?id=e5062028978' target=_blank style='color:#2F92EE;'>#不典型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20289, encryptionId=e5062028978, topicName=不典型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Mon Oct 28 22:12:00 CST 2019, time=2019-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278142, encodeId=a35912e81428b, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat May 11 04:12:00 CST 2019, time=2019-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1311939, encodeId=98471311939a1, content=<a href='/topic/show?id=21a6e54280e' target=_blank style='color:#2F92EE;'>#穿刺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75428, encryptionId=21a6e54280e, topicName=穿刺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Sat May 11 04:12:00 CST 2019, time=2019-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609772, encodeId=67331609e724b, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat May 11 04:12:00 CST 2019, time=2019-05-11, status=1, ipAttribution=)]
    2019-05-11 仁者大医

    #活检#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1786280, encodeId=8a8c1e862803d, content=<a href='/topic/show?id=569f13e9045' target=_blank style='color:#2F92EE;'>#Pathol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13790, encryptionId=569f13e9045, topicName=Pathol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Tue Mar 10 06:12:00 CST 2020, time=2020-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005303, encodeId=1c35200530371, content=<a href='/topic/show?id=0f4de5432ce' target=_blank style='color:#2F92EE;'>#穿刺活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75432, encryptionId=0f4de5432ce, topicName=穿刺活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1c2e485, createdName=yangfl06, createdTime=Tue Oct 29 11:12:00 CST 2019, time=2019-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2023245, encodeId=85bc202324507, content=<a href='/topic/show?id=edd6e842119' target=_blank style='color:#2F92EE;'>#经皮穿刺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78421, encryptionId=edd6e842119, topicName=经皮穿刺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Mon Dec 23 20:12:00 CST 2019, time=2019-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898649, encodeId=03321898649aa, content=<a href='/topic/show?id=e5062028978' target=_blank style='color:#2F92EE;'>#不典型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20289, encryptionId=e5062028978, topicName=不典型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Mon Oct 28 22:12:00 CST 2019, time=2019-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278142, encodeId=a35912e81428b, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat May 11 04:12:00 CST 2019, time=2019-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1311939, encodeId=98471311939a1, content=<a href='/topic/show?id=21a6e54280e' target=_blank style='color:#2F92EE;'>#穿刺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75428, encryptionId=21a6e54280e, topicName=穿刺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Sat May 11 04:12:00 CST 2019, time=2019-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609772, encodeId=67331609e724b, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat May 11 04:12:00 CST 2019, time=2019-05-11, status=1, ipAttribution=)]
    2019-05-11 rgjl

    #穿刺#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1786280, encodeId=8a8c1e862803d, content=<a href='/topic/show?id=569f13e9045' target=_blank style='color:#2F92EE;'>#Pathol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13790, encryptionId=569f13e9045, topicName=Pathol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Tue Mar 10 06:12:00 CST 2020, time=2020-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005303, encodeId=1c35200530371, content=<a href='/topic/show?id=0f4de5432ce' target=_blank style='color:#2F92EE;'>#穿刺活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75432, encryptionId=0f4de5432ce, topicName=穿刺活检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1c2e485, createdName=yangfl06, createdTime=Tue Oct 29 11:12:00 CST 2019, time=2019-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2023245, encodeId=85bc202324507, content=<a href='/topic/show?id=edd6e842119' target=_blank style='color:#2F92EE;'>#经皮穿刺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78421, encryptionId=edd6e842119, topicName=经皮穿刺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Mon Dec 23 20:12:00 CST 2019, time=2019-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898649, encodeId=03321898649aa, content=<a href='/topic/show?id=e5062028978' target=_blank style='color:#2F92EE;'>#不典型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20289, encryptionId=e5062028978, topicName=不典型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Mon Oct 28 22:12:00 CST 2019, time=2019-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278142, encodeId=a35912e81428b, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat May 11 04:12:00 CST 2019, time=2019-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1311939, encodeId=98471311939a1, content=<a href='/topic/show?id=21a6e54280e' target=_blank style='color:#2F92EE;'>#穿刺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75428, encryptionId=21a6e54280e, topicName=穿刺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Sat May 11 04:12:00 CST 2019, time=2019-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609772, encodeId=67331609e724b, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat May 11 04:12:00 CST 2019, time=2019-05-11, status=1, ipAttribution=)]
    2019-05-11 ms3994565386320060

    #Med#

    0