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细针穿刺活检:如何准备和会发生什么 | Most cancers.Web

Fasting Spotlight by Fasting Spotlight
March 9, 2023
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细针穿刺活检:如何准备和会发生什么 | Most cancers.Web
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为了检查您身体的某个部位是否患有癌症,您的医生可能会建议进行细针穿刺活检。本文的信息可以帮助您了解这一程序,并为您的约诊做好准备。

什么是细针穿刺活检? 

活检 (英文) 从可能的肿瘤或关注部位采集组织,以便在显微镜下进行检查该样本。还可以对活检样本进行未必涉及显微镜的其他检测。活检是医生诊断大多数类型癌症的主要方法。活检有多种类型,其中包括细针穿刺活检。

为了进行细针穿刺活检,医生会将一根非常细的空心针刺入皮肤并插入怀疑部位。与针头相连的注射器会吸出一小块细胞样本,有时会吸出液体。这一程序也可称为细针活检或 FNA。在不同活检方法中,这种方法侵入性最小,称为微创方法。

细针穿刺活检还可能在内窥镜检查或支气管镜检查期间进行。内窥镜检查是一种允许医生查看患者体内情况的程序,支气管镜检查是一种允许医生查看患者肺内情况的程序。了解有关内窥镜检查类型以及如何准备内窥镜检查的更多信息 (英文)。

为什么我可能需要进行细针穿刺活检?

大多数癌症只能通过活检确诊。如果医生感觉到您的皮肤下面有肿块,可能会建议进行细针穿刺活检。如果他们在其他检测和程序 (英文) 中发现可疑情况,也可能建议进行这一活检。如果肿块在体内较深部位,则超声 (英文)、计算机断层扫描 (英文) 或磁共振成像 (英文) 等影像学检查可以帮助将活检针引导到正确部位。这称为影像引导活检。

活检可由您的医生、病理医生或放射科医生进行。病理医生是专门负责解读实验室检查结果并评估细胞、组织和器官以诊断疾病的医生。放射科医生是专门利用影像学检查诊断疾病的医生。

使用细针穿刺活检检查癌症的常见身体部位包括甲状腺、淋巴结、乳腺、肝脏、肺和皮肤。但是,这一程序可用于身体的大多数部位。

之后,会将活检期间采集的组织送往实验室,以便病理医生对其进行分析。您的活检结果将显示切取的组织是否来自肿瘤。如果存在肿瘤,活检将有助于揭示是癌性还是良性肿瘤。癌性肿瘤为恶性肿瘤,这意味着它会生长并可能扩散到身体的其他部位。良性肿瘤意味着肿瘤会生长但不会扩散。这些信息对于帮助您的医生确定是否需要进一步的诊断性检测非常重要。如果不需要进一步的检测,它可以帮助医生为您推荐最佳治疗计划。

对于已经诊断患有癌症的患者,细针穿刺活检也可用于评估关注部位是否与癌症扩散到身体其他部位(称为转移)有关。或者,可用于确定是否形成了一种新的不同类型的癌症,称为第二种癌症 (英文)。

“细针穿刺活检是一种广泛使用的微创方法,用于帮助诊断新发或复发癌症,通常风险非常低。” ——Jeffrey E. Gershenwald,医学博士,美国外科医师学会会员,德克萨斯州休斯顿德克萨斯大学安德森癌症中心外科部肿瘤外科教授,Most cancers.Web 编辑委员会 (英文) 成员。

在细针穿刺活检期间,预期会发生什么?

细针穿刺活检可能在医生办公室或门诊进行。如果需要影像引导活检,放射科医生可能在成像设施、医院或其他医疗中心进行。您可能需要脱下衣服并穿上病号服,具体取决于您身体的活检部位。还将根据活检部位决定您是需要坐着还是仰卧、侧卧或俯卧。在程序过程中保持静止很重要。

您的医生可能会先在皮肤上涂抹外用药物,麻醉活检部位。有时,他们会将药物注射到活检部位,以防止皮下组织疼痛。之后,他们会插入活检针。程序期间,医生可能会重复一次以上活检,以从怀疑区域的不同部位采集组织。整个程序可能需要 15 分钟至 1 小时,具体取决于受累的身体部位以及是否使用成像。

在进行细针穿刺活检之前,我应该怎么做?

您无需做太多准备来进行细针穿刺活检。您的医生可能会要求您在检测前几天暂时停用某些药物,包括血液抗凝剂,如阿司匹林、氯吡格雷(波立维)和华法林 (Coumadin)。在进行计划的程序之前,最好询问医生您是否应该停用或避免使用所有药物。

在您前来参加约诊时,您的医生或医疗保健团队的其他成员将确保您了解活检程序的获益与风险,并要求您审阅并签署一份同意书。如果在程序前您有任何疑虑,请咨询您的医生。此外,请询问您的医生您将如何获得活检结果,以及谁会向您解释这些结果。实验室通常会在 2 至 3 天内出具结果,但有时可能需要更长时间。

细针穿刺活检后的恢复情况如何?

大多数细针穿刺活检程序后通常不需要恢复时间。医生可能会在活检部位贴一小块绷带。会为您提供程序后的所有特殊护理说明。大多数细针穿刺活检程序后,您可以开车回家,并立即恢复正常活动。

有时,活检部位可能会感到疼痛。在罕见情况下,可能发生感染或出血。如果您出现发热或活检部位持续出血、肿胀或疼痛且未停止,请立即致电您的医生。

出具活检结果时会发生什么? 

仅仅进行细针穿刺活检,并不意味着您患有癌症。怀疑部位可能是非癌性的。或者,您可能有异常细胞,可以在癌变之前将其切除或破坏。如果病理医生需要更多的组织来做出诊断,您可能需要重复活检或进行不同的程序。

如果活检确实诊断出新发癌症,病理报告 (英文) 中的癌症类型 (英文) 及其分期 (英文) 等信息可帮助您的医生将您转诊至肿瘤科医生进行治疗。肿瘤科医生是癌症专家。该报告还可能包括有关特定基因、蛋白质和肿瘤特有的其他因素的信息,这些信息可以帮助指导您的治疗方案。

请让医生向您解释病理报告的不同部分,以便您清楚地了解您的诊断。在癌症治疗开始前,您可能需要在细针穿刺活检后进行进一步检查,以确定您的诊断。



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