Feasibility study on CT guided percutaneous incisional needle biopsy for deep pelvic masses by different puncture approaches / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the feasibility of CT guided percutaneous incisional needle biopsy (PINB) for deep pelvic masses at different locations via various puncture approaches.</p><p><b>METHODS</b>PINBs under CT guidance were performed in 70 patients with 72 pelvic lesions through different puncture approaches. Their pathological findings and safety were evaluated after follow-up of a period of 1-34 months.</p><p><b>RESULTS</b>PINBs were performed through transpiriform-muscle in 27 cases, 16 through transgluteal approach, 5 through posterior oblique approach in prone position, 8 by anterior or lateral transabdominal route, 8 through iliopsoas muscle and 8 by direct transosseous approach, respectively. Sixty-four malignant lesions were confirmed by pathology, including 30 adenocarcinomas, 19 squamous cell carcinomas, 5 unclassified malignant tumors, 3 small cell carcinomas, 2 malignant giant cell tumors of bone, 2 hepatocellular carcinomas and 3 false negative lesions which were confirmed at the second PINBs as malignant tumors, respectively. Benign neoplasms were confirmed in 8 cases, including fibrosis tissue in 6 lesions, bone tuberculosis in 1 and ovarian cyst in 1. The sensitivity, specificity, and accuracy rate were 95.3% (61/64), 100% (8/8), and 95.8% (69/72), respectively. Twenty-two cases via transpiriform-muscle approach suffered from transient deep pelvic pain which radiated to the lower limbs of the same side. No hematoma, nerve damage, infection, and tumor transplantation in pelvic cavity developed after the PINB procedure.</p><p><b>CONCLUSION</b>CT guided percutaneous incisional needle biopsy through different puncture approaches is safe and feasible for the patients with deep masses at different locations in the pelvic cavity.</p>

Transcatheter arterial chemoembolization combined with tumor necrosis factor for primary hepatic cancer / 肿瘤

Objective: To observe and compare short-term therapeutic effect and adverse effect of recombinant mutant human tumor necrosis factor (rmhTNF) via transcatheter arterial chemoembolization in the treatment of primary hepatic cancer. Methods: Sixty patients with confirmed primary hepatic cancer in clinic were randomly divided into two groups (n = 30). Group A (therapeutic group) received conventional TACE first and then the catheter was inserted into the hepatic artery and rmhTNF, chemotherapeutic drugs, and hyper liquid iodide oil were emulsified and infused to induce intraarterial embobilization. Group B (control group) received one cycle of conventional TACE and the second cycle of conventional TACE 1 month later. After two cycles of interventional treatment the short-term therapeutic effect and adverse reaction of the two groups were evaluated. Results: Comparison of two groups, the tumor volume were obviously reduced in the therapeutic group. There was significant difference in the short-term therapeutic efficacy (P 0.05). Some patients experienced shiver after infusion of rmhTNF. Conclusion: TACE combined with rmhTNF is an effective method for primary hepatic cancer with good short-term outcome and no obvious adverse reaction. It is worthy of popularization in clinic.

Port catheter system placement in pulmonary artery via percutaneous subclavicle vein treatment for refractory multiple metastatic tumors in the two lungs:efficacy evaluation and technique discussion / 肿瘤研究与临床

Objective To evaluate the efficacy of port catheter system(PCS)placement in pulmonary artery via percutaneous subclavicle vein treatment for multiple metastatic tumor in the two lungs and discuss the PCS technique.Methods Fifteen multiple metastatic tumor patients(13 hepatocellular carcinomas,one mandible grand adenocarcinoma,one oral bottom squamous carcinoma)were carried out with pulmonary artery PCS placement by way of percutaneous subclavicle vein.FPA/FPM/GP chemotherapy scheme were introduced every 4～6 weeks.Results The success rate of PCS placement technique was 93.3%(14/15).One case failed.Percutaneous subclavicle veins were performed 14 cases in right side and 1 in left one.Following up 2～43 months,2～7 chemotherapy cycles(mean 5 cycles)were accomplished,and the clinical CR and PR were achieved in 1 and 3 cases respectively with clinical efficacy rate 28.6%(4/14).Major side reaction was late wound healing in 1 case.Conclusion PCS placement in pulmonary artery treatment for multiple metastatic tumor in the two lungs is effective,and mastering operation technique is the key for increasing operation suc- cess rate.