Nyob rau hauv ib puas-evolving toj roob hauv pes ntawm kev kho mob diagnostics,koob tshuaj biopsyua lub luag haujlwm tseem ceeb hauv kev tau txais cov qauv ntaub so ntswg rau kev kuaj kab mob kom raug, thiab lawv cov kev xaiv yog ncaj qha cuam tshuam txog kev kuaj ntshav biopsy, kev nyab xeeb thiab kev paub ntawm tus neeg mob. Hauv qab no yog ib qho kev soj ntsuam ntawm cov txheej txheem biopsy,hom koob tshuaj biopsy, core-rau-fine koob sib piv, thiab cov kev xaiv tseem ceeb los muab cov lus qhia zoo rau kev kho mob.
1. Nkag siab txog cov txheej txheem biopsy
Lub hom phiaj tseem ceeb ntawm tus txheej txheem biopsy yog kom tau txais cov qauv ntaub so ntswg zoo kom paub meej qhov xwm txheej ntawm qhov txhab lossis tsim kho cov phiaj xwm. Qhov xav tau rau ib rab koob biopsy nws txawv heev ntawm cov xwm txheej biopsy:
- Kev kuaj mob qog nqaij hlav: cov ntaub so ntswg txaus yuav tsum tau los txhawb cov txheej txheem pathologic thiab kuaj caj ces (xws li EGFR, ALK kev hloov pauv).
- Cov kab mob ua rau mob: cytology yuav tsum tau qhia meej cov kab mob lossis hom kab mob tiv thaiv kab mob.
- Kev ntsuam xyuas ua ntej: yuav tsum tau txais cov qauv sai sai los qhia cov txheej txheem phais (xws li kev txheeb xyuas ntawm cov mis mos thiab cov mis mos).
2. Hom ntawmkoob tshuaj biopsythiab kev siv tshuaj kho mob
- Lub hauv paus ntsiab lus: Tau txais ib daim kab xev ntawm cov ntaub so ntswg los ntawm kev txiav tshuab.
- Qhov zoo:
Ua kom tiav cov qauv, haum rau cov qog nqaij hlav (piv txwv li, lub mis, prostate) thiab pob txha nqaij biopsy.
Cov qauv loj yog txaus los txhawb immunohistochemistry thiab kuaj molecular.
- Cov kev txwv: kev raug mob loj heev, yuav tsum nruj me ntsis tuav cov lus qhia.
(2) Fine Aspiration Biopsy Koob
- Lub hauv paus ntsiab lus: Siv qhov tsis zoo siab nqus kom tau txais kev ncua ntawm tes.
- Qhov zoo:
Kev puas tsuaj tsawg dua, haum rau cov qog nqaij hlav qog nqaij hlav, cov thyroid thiab mob ntsws.
Yooj yim rau kev ua, tuaj yeem tau txais kev ncua ntawm tes.
Yooj yim ua, tso cai rau kev kuaj mob cytologic sai.
- Cov kev txwv: cov qauv fragmentation, tsis tuaj yeem ua tau raws li qhov xav tau ntawm kev kuaj histological.
(3) Vacuum-Assisted Biopsy Needle (VAB)
- Lub hauv paus ntsiab lus: Sib txuas cov tshuab txiav thiab tsis zoo siab nqus los txhim kho cov qauv kev ua haujlwm.
- Qhov zoo:
Ntau cov qauv tuaj yeem tau txais hauv ib qho puncture, haum rau lub mis microcalcified foci.
Txo qhov kev pheej hmoo ntawm kev rov ua dua thiab txhim kho cov neeg mob siab ntev.
(4) Txiav Biopsy koob
- Lub hauv paus ntsiab lus: cov ntaub so ntswg yog txiav los ntawm ib tug grooved taub hau los yog rotating hniav.
- Hom:
Slotted Needle: xws li Tru-Cut Biopsy Needle, rau cov ntaub so ntswg mos.
Ntiv nplhaib Drill Needle: Piv txwv li Pob Txha Pob Txha Biopsy Koob, rau cov pob txha pob txha.
3. core needle biopsy vs fine needle aspiration
| Qhov taw qhia | Core koob biopsy | Fine koob aspiration |
| Hom qauv | Sawb cov ntaub so ntswg | Cell ncua |
| Diagnostic raug | Siab (histology) | Nruab nrab (cytology) |
| Degree ntawm kev raug mob | Loj dua | Me me |
| Lub sijhawm ua haujlwm | Ntev dua | luv dua |
| Cov xwm txheej | Cov qog nqaij hlav, pob txha pob txha | Cov kab mob ntawm daim tawv nqaij, lymph nodes |
4. Cov yam tseem ceeb uas yuav tsum tau xav txog thaum xaiv cov koob tshuaj biopsy zoo
(1) Biopsy lub hom phiaj
- Cov khoom nruab nrog cev (piv txwv li, cov thyroid, lub mis): cov koob zoo lossis cov koob tseem ceeb yog qhov zoo dua rau kev sib npaug ntawm kev raug mob thiab kev kuaj mob.
- Cov kab mob sib sib zog nqus (piv txwv li, daim siab, lub raum): qhov ntev ntawm cov tub ntxhais biopsy koob yog nyiam los xyuas kom meej qhov tob ntawm kev nkag mus.
- Cov ntaub so ntswg: lub nplhaib tho koob (xws li cov pob txha pob txha biopsy koob) yuav tsum tau siv kom tsis txhob muaj cov ntaub so ntswg tawg.
(2) Cov yam ntxwv tshwj xeeb ntawm tus neeg mob
- Hnub nyoog thiab kev cai lij choj: cov menyuam yaus lossis cov neeg mob tsis muaj zog yuav tsum xaiv ib rab koob nyias (xws li 20G) kom txo tau cov teeb meem.
- Coagulation muaj nuj nqi: cov neeg mob uas muaj coagulation disorders yuav tsum tsis txhob co coarse koob (piv txwv li, 16G) kom txo tau txoj kev pheej hmoo ntawm los ntshav.
- Kev puas siab puas ntsws: Cov neeg mob ntxhov siab tuaj yeem nyiam cov koob txhaj tshuaj nqus tsev vacuum kom txo lub sijhawm ua haujlwm.
(3) Cov ntaub so ntswg ceev thiab qhov chaw
- Cov ntaub so ntswg (piv txwv li, prostate, siab): xaiv ib rab koob biopsy uas muaj zog txiav (xws li, 18G slotted koob).
- Cov hlab ntsha / cov hlab ntsha nyob sib ze: ultrasound / CT-coj kev ua haujlwm yog yuav tsum tau xaiv lub koob txhaj tshuaj biopsy.
(4) Koob loj thiab ntev
- Specification xaiv:
Fine koob (20-22G): rau cytology lossis kab mob ntawm daim tawv nqaij.
Coarse needle (14-18G): haum rau kev kuaj histological lossis qhov mob tob.
- Kev xaiv ntev: txiav txim siab los ntawm qhov tob ntawm kev sib tsoo (xws li lub ntsws biopsy yuav tsum yog ≥15cm).
(5) Koob tip design
- Beveled koob taub: haum rau cov ntaub so ntswg kom txo tau qhov tsis kam.
- Peb-pronged taub: siv tau rau cov pob txha pob txha, txhawm rau txhim kho kev nkag mus.
- Kos npe: MRI-guided biopsy koob yuav tsum tau sau nrog titanium alloy.
(6) Compatibility nrog cov qauv duab
- Ultrasound kev taw qhia: Biopsy koob nrog tsim rings yuav tsum tau xaiv.
- CT / MRI kev taw qhia: cov khoom tsis muaj hlau nplaum lossis cov khoom siv qis (xws li titanium alloy) yuav tsum tau xaiv.
(7) Qauv rho tawm mechanism
- Mechanical txiav: muaj feem xyuam rau cov qog nqaij hlav uas ua tiav cov qauv.
- Tsis zoo siab nqus: haum rau kev kuaj cytologic, yooj yim rau kev khiav lag luam.
- Nqus-pab: muaj feem xyuam rau ntau qhov chaw sampling, txhim kho efficiency.
(8) Tus neeg mob kev nplij siab thiab kev nyab xeeb
- Kev tswj qhov mob: koob zoo tsis tshua muaj kev raug mob thiab ntau dua rau cov neeg mob.
- Kev tiv thaiv teeb meem: tsis txhob rov ua dua nrog rab koob tuab, txo qhov kev pheej hmoo ntawm pneumothorax thiab los ntshav.
(9) Tus nqi thiab kev nkag tau yooj yim
- Tus nqi ua tau zoo: tag nrho cov koob txhaj tshuaj biopsy (piv txwv li, TSK) yog kim dua, tab sis muaj qhov ua tau zoo ntawm cov qauv.
- Kev tuav pov hwm kho mob: yuav tsum xaiv cov khoom nyob rau hauv cov nyiaj them rov qab raws li cov cai hauv zos.
5. Cov lus xaus
Kev xaiv ntawmkoob tshuaj biopsyyuav tsum muaj kev ntsuam xyuas dav dav ntawm qhov xwm txheej ntawm qhov mob, tus neeg mob xwm txheej, kev mob nkeeg thiab kev lag luam. Hauv kev kho mob, cov hauv qab no yuav tsum tau ua raws li:
1. kev sib txuam meej: xaiv hom koob raws li lub hom phiaj ntawm kev kuaj ntshav (xws li 14G grooved koob rau lub mis, 20G koob zoo rau cov thyroid).
2. Ua ntej kev nyab xeeb: zam cov koob tuab rau cov neeg mob uas muaj kab mob coagulation, thiab ua haujlwm raws li cov duab taw qhia rau cov kab mob vascular uas nyob ib sab.
3. Kev ua tau zoo thiab kev nplij siab: cov koob siv lub tshuab nqus tsev tuaj yeem txhim kho kev ua haujlwm zoo, thiab cov koob zoo tuaj yeem txo cov neeg mob.
Los ntawm kev tshawb fawb ntawm cov koob tshuaj biopsy, qhov kev kuaj pom tseeb tuaj yeem txhim kho tau zoo, qhov kev pheej hmoo ntawm cov teeb meem tuaj yeem raug txo qis, thiab qhov kawg ntawm tus kheej cov tshuaj precision tuaj yeem ua tiav.
Post lub sij hawm: May-19-2025