Mis Core Needle Biopsy: Cov Ntawv Thov Kev Kho Mob Thiab Cov Kev Ntsuas Tus Kheej Thiab Kho Cov Tswv Yim

https://www.mayoclinic.org/tests-procedures/breast-biopsy/about/pac-20384812
Kev ntsuam xyuas raug thiab kev pheej hmoo stratification ntawm cov neeg tsis txaus ntseeg
Core needle biopsy ntawm lub mis uas tsis txaus ntseeg yog ib qho tseem ceeb hauv kev kuaj mob ntxov ntxov ntawm mob qog noj ntshav, nrog rau kev txiav txim siab kho mob raws li kev ntsuam xyuas dav dav ntawm cov duab kos duab, kev tshawb fawb soj ntsuam palpation, thiab cov neeg mob muaj feem pheej hmoo. Ultrasound-cov tub ntxhais koob txhaj tshuaj yog siv tau rau ob qho tib si palpable thiab tsis yog- palpable masses, thiab nws qhov kev kuaj mob raug cuam tshuam los ntawm qhov loj me, tus yam ntxwv ntawm ciam teb, thiab echogenicity sab hauv. Qhov kev ua tiav ntawm kev ua tiav ntawm biopsy yog kwv yees li 85-90% rau qhov loj dua 1 cm, nce mus rau 92-95% rau 1-2 cm loj, thiab nce mus txog 95-98% rau cov loj dua 2 cm. Cov pawg nrog cov ciam teb tsis tu ncua, cov npoo npoo npoo, lossis qhov sib piv ntau dua 1 feem ntau yuav ua rau mob tsis zoo, thiab cov yam ntxwv no coj cov kev xaiv ntawm lub hom phiaj rau kev kuaj xyuas thaum kuaj ntshav.
Tsis yog -palpable masses kuaj pom los ntawm kev tshuaj ntsuam mammographic yuav tsum tau stereotactic biopsy, thiab cov kab mob no feem ntau tshwm sim raws li architectural distortion los yog asymmetric ntom. Tus nqi malignancy rau architectural distortion yog kwv yees li 15-30%, siab dua li ntawm ib leeg pawg, yuav tsum muaj ntau -cov qauv sau thaum lub sij hawm biopsy los xyuas kom meej cov neeg sawv cev. Digital mis tomosynthesis (DBT) txhim kho tus nqi kuaj pom thiab kuaj qhov tseeb ntawm kev sib txawv ntawm cov vaj tse; DBT-kev coj noj coj ua tuaj yeem ua kom qhov tseeb ntawm kev kuaj mob rau cov kab mob no los ntawm 75% mus rau 90%. Rau ntau qhov pom ntawm mammography tab sis tsis yog ntawm ultrasound, MRI-kev coj noj coj ua yog qhov kev xaiv tseem ceeb. Cov kab mob no suav nrog 3-5% ntawm tag nrho cov biopsies, tab sis nyob rau hauv cov poj niam uas muaj lub mis tuab, lawv feem yuav ncav cuag 8-10%.
Kev kuaj mob sib txawv ntawm cov hlwv nyuaj thiab cystic- cov khoom loj yog nyob ntawm koob tshuaj biopsy. Cov hlwv yooj yim feem ntau tsis tas yuav tsum tau kuaj ntshav, tab sis cov hlwv nyuaj-cov hlwv sab hauv tuab dua 0.5 hli, cov khoom sib xyaw ua ke, lossis cov cim ntshav ntau ntau- ua rau muaj kev pheej hmoo siab ntawm kwv yees li 1–5% thiab yog li yuav tsum tau kuaj ntshav kom tsis suav nrog. Rau cystic- cov khoom loj, ob qho tib si cyst kua thiab cov khoom siv yuav tsum tau coj mus kuaj thaum kuaj ntshav; combining cytological tsom xam ntawm lub cyst kua nrog histological kev ntsuam xyuas ntawm cov khoom muab cov ntaub ntawv qhia txog kev kuaj mob. Lub tshuab nqus tsev{10}}pab biopsy yog tshwj xeeb tshaj yog haum rau cov kab mob no, ua rau muaj kev kuaj mob ib txhij thiab cov kua dej tawm hauv lub cev, nrog rau kev kuaj pom tseeb tshaj 95%.
Biopsy strategies for high-risk lesions require special consideration. The diagnostic accuracy of preoperative core needle biopsy for phyllodes tumors is approximately 80–85%, lower than the 95% accuracy for invasive carcinomas, due to tumor heterogeneity that may lead to sampling bias. For such lesions, multi-site sampling (at least 3–5 sites) and sufficient tissue acquisition (total sample volume >100 mg) raug pom zoo. Radiating caws pliav ua rau muaj kev sib tw ntau dua, vim tias lawv cov fibrosis hauv nruab nrab zoo ib yam li cov tshuaj tiv thaiv desmoplastic pom nyob rau hauv cov kab mob loj heev; Kev ntsuam xyuas immunohistochemical yog xav tau rau kev sib txawv, thiab biopsies yuav tsum ua qhov tseem ceeb ntawm cov qauv ntawm thaj tsam nruab nrab ntawm cov qauv radial.
Cov kev sib tw hauv Nrhiav Microcalcifications thiab Sampling Strategies
Mis microcalcifications yog lub cim tseem ceeb ntawm kev mob qog noj ntshav thaum ntxov, suav txog kwv yees li 50% ntawm cov kev tshawb pom txawv txav hauv kev kuaj mammographic. Txawm li cas los xij, lawv rab koob biopsy nthuav qhia cov kev sib tw tshwj xeeb. Microcalcifications raug cais raws li morphology thiab kev faib tawm mus rau hauv hom benign, nruab nrab, thiab tsis txaus ntseeg malignant hom. Raws li American College of Radiology's BI-RADS classifications, calcifications categorized as category 4 (suspicious) los yog qeb 5 (highly suggestive of malignancy) xav tau kev soj ntsuam biopsy. Clustered faib (ntau tshaj tsib ib square centimeter), pleomorphic, linear, los yog segmental calcifications muaj kev pheej hmoo siab tshaj ntawm malignancy, mus txog 50-80%.
Stereotactic biopsy yog tus qauv txheej txheem rau microcalcifications, nrog kev pom zoo ntawm calcification retrieval yog qhov tseem ceeb rau nws txoj kev vam meej. Preoperative localization imaging txheeb xyuas qhov chaw calcification thiab suav cov koob txhaj tshuaj nrog qhov tseeb ntawm ± 1 hli. Tam sim ntawd tshaj tawm-sampling X-ray imaging ntawm cov qauv yog ib qho tsim nyog tswj cov kauj ruam kom paub meej tias calcifications tau txais. Cov kev tshawb fawb qhia tau hais tias tsis tseeb tus nqi tsis zoo rau biopsies yam tsis tau muab cov calcifications tuaj yeem siab li 30-40%, thaum kuaj qhov tseeb tshaj 95% thaum cov calcifications tau tiav. Rau kev tawg lossis tawg calcifications, ntau qhov chaw kuaj xyuas yuav tsum tau ua kom muaj kev sawv cev, nrog tsawg kawg 5-8 cov qauv feem ntau pom zoo.
Lub tshuab nqus tsev-pab biopsy muaj qhov txiaj ntsig tseem ceeb hauv kev ua piv txwv microcalcifications, nrog rau ib qho piv txwv ntawm 3 mus rau 5 npaug ntau dua li cov koob tseem ceeb, thiab qhov kev vam meej tau txais calcifications nce ntawm 75% mus rau ntau dua 90%. Cov qauv loj dua-feem ntau yog 8 txog 12 tus qauv- tsis yog txhim kho qhov tseeb ntawm kev kuaj mob nkaus xwb tab sis kuj tseem muaj cov khoom siv txaus rau kev kuaj molecular. Rau thaj chaw calcified ntau, lub tshuab nqus tsev{11}}pab biopsy tuaj yeem ua tiav ob qho kev kuaj mob thiab kev kho mob los ntawm kev tshem tawm cov calcifications tag nrho, yog li zam kev phais. Cov kev tshawb fawb pom tau tias lub tshuab nqus tsev{13}}pab biopsy ua tiav cov nqi txiav tawm ntawm 85–90% rau cov calcifications benign.
Biopsy ntawm calcifications pom tsuas yog hauv MRI nthuav tawm qhov kev sib tw tshwj xeeb, vim tias cov calcifications tsis tuaj yeem kuaj pom ntawm mammography lossis ultrasound thiab pom tsuas yog hauv MRI. Lawv tshwm sim nyob rau hauv kwv yees li 2-3% ntawm cov neeg mob, tab sis qhov tshwm sim tuaj yeem ncav cuag 5-8% hauv cov neeg muaj kev pheej hmoo siab (xws li BRCA hloov pauv). MRI-kev coj noj coj ua yuav tsum muaj cov cuab yeej tshwj xeeb uas tsis yog- cov khoom sib nqus, thiab yuav tsum tau kuaj ntau yam thaum lub sijhawm ua haujlwm kom paub meej tias qhov kev tso koob, ua rau lub sijhawm ua haujlwm ntev dua (feem ntau 60–90 feeb). Tus nqi malignancy rau xws li calcifications yog li ntawm 20-30%, me ntsis siab dua li cov calcifications pom nyob rau hauv mammography, tej zaum vim lawv koom nrog ua ntej malignant hloov.
Postoperative marker clip placement yog ib qho tseem ceeb rau kev tswj xyuas tom ntej, tshwj xeeb tshaj yog thaum lub biopsy tshem tawm cov kab mob calcified. Cov cim clip yog pom nyob rau hauv X-ray thiab muab qhov chaw nyob rau yav tom ntej kev phais lossis kev kho hluav taws xob. Cov clip yuav tsum tau muab tso rau ze li sai tau rau qhov chaw ntawm qhov chaw ntawm lub cev nqaij daim tawv, yam tsawg kawg yog 1 cm deb ntawm kab noj hniav ntug, txhawm rau tiv thaiv kev txav mus los. Marker clip placement yog ib qho tseem ceeb tshwj xeeb hauv cov neeg mob uas tau txais kev kho neoadjuvant, ua kom muaj qhov tseeb hauv cheeb tsam ntawm thawj qhov txhab ua ntej thiab tom qab kev kho mob.
Neoadjuvant Therapy Efficacy Evaluation and Prediction of Pathological Complete Response
Pre-treatment biopsy not only provides diagnosis but also serves as a baseline sample for assessing treatment response and studying resistance mechanisms. Pre-treatment biopsies should obtain sufficient tissue (at least 3–4 core samples with a total length >40 mm), thiab ob qho tib si niaj hnub histopathological thiab molecular tsom xam yuav tsum tau ua. Kev ntsuas tseeb ntawm cov tshuaj hormones receptors (ER, PR), HER2 raws li txoj cai, thiab Ki-67 Performance index yog qhov tseem ceeb rau kev txiav txim siab txog kev kho mob-, thiab kev sim rau cov cim no yuav tsum muaj cov ntaub so ntswg txaus thiab zoo.
Kev soj ntsuam kev kho mob teb los ntawm biopsy thaum lub sij hawm kho yog ib qho kev nce qib tseem ceeb hauv precision oncology. Kev ntsuam xyuas kev ua tau zoo ib txwm nyob ntawm kev ntsuas, tab sis kev hloov pauv hauv cov qog ntim qis qis dua qib molecular - hloov pauv. Thaum ntxov biopsies tau ua 2-4 lub lis piam tom qab kev kho mob tuaj yeem kuaj pom cov qog cell apoptosis, proliferation inhibition, thiab microenvironmental hloov, yog li kwv yees cov txiaj ntsig kho zaum kawg. Cov kev tshawb fawb qhia tau hais tias cov neeg mob uas nws qib Ki-67 txo qis dua 50% tom qab ob lub lis piam ntawm neoadjuvant chemotherapy muaj cov kab mob ua tiav cov lus teb (pCR) tus nqi 3 mus rau 4 npaug ntau dua li cov uas muaj tsawg dua 50% txo. Qhov kev ntsuam xyuas thaum ntxov no ua rau muaj kev hloov kho raws sij hawm ntawm cov tswv yim kho mob, zam kev siv tsis tau ntev.
Cov qauv kev kwv yees rau cov lus teb ua tiav pathology suav nrog kev kho mob, kev kuaj pom, thiab cov yam ntxwv molecular. Tumor subtype yog qhov muaj zog tshaj qhov kwv yees, nrog pCR tus nqi ntawm 30–40% hauv triple-negative thiab HER2-mob qog noj ntshav zoo siab dua hauv cov tshuaj hormone receptor-mob qog noj ntshav zoo (5–10%). Ua ntej- kho mob qog-infiltrating lymphocytes (TILs) sawv cev rau lwm qhov kev kwv yees tseem ceeb, nrog pCR tus nqi nce mus txog 60% hauv triple- mob qog noj ntshav mis tsis zoo thaum TILs ntau dua 20%. Gene qhia profiles xws li PAM50 subtyping thiab kev tiv thaiv kab mob ntsig txog cov noob caj noob ces ntxiv kev twv ua ntej, txawm hais tias cov ntaub so ntswg txaus xav tau rau kev tshuaj xyuas RNA.
Kev ntsuam xyuas tseeb ntawm cov kab mob uas nyob ze yuav qhia txog kev kho mob tom ntej. Cov neeg mob uas tsis ua tiav pCR tom qab kev kho neoadjuvant muaj kev pheej hmoo siab dua ntawm kev rov tshwm sim dua thiab xav tau kev kho mob ntxiv. Thaum ntsuam xyuas cov kab mob uas nyob ntawm qhov tseem ceeb ntawm cov koob txhaj tshuaj, qhov kev kuaj tus neeg sawv cev yog qhov tseem ceeb, vim tias cov qog tuaj yeem tawg mus rau hauv ntau qhov me me foci post-kev kho mob, yuav tsum muaj ntau- qhov chaw kuaj. Immunohistochemical re-Kev ntsuam xyuas ntawm cov tshuaj hormone receptor thiab HER2 xwm txheej yog qhov tseem ceeb, vim tias cov cim no hloov pauv hauv kwv yees li 10-15% ntawm cov neeg mob, cuam tshuam rau kev txiav txim siab kho mob. Kev tshawb nrhiav cov kab mob nyob hauv molecular los ntawm kev txheeb xyuas cov qog DNA tuaj yeem kwv yees qhov rov tshwm sim ua ntej cov kab mob kis tau tshwm sim, tab sis yuav tsum tau ua ntej - cov qauv kho cov ntaub so ntswg los tsim kom muaj ib qho kev hloov pauv ntawm tus kheej.
Kev tshawb nrhiav kev txhais lus siv cov qauv biopsy tsav kev txhim kho cov tshuaj tshiab. Kev sib piv cov qauv ua ntej thiab tom qab kev kho mob tuaj yeem nthuav tawm cov txheej txheem tiv thaiv, xws li kev ua kom lub PI3K txoj hauv kev thiab kev txhim kho ntawm lub cev tiv thaiv kab mob. Tib -cell RNA sequencing ua rau kev soj ntsuam ntawm cov qog heterogeneity thiab kev hloov pauv hauv microenvironment, txheeb xyuas cov neeg subpopulations rhiab lossis tiv thaiv kev kho. Cov kev tshawb fawb no tsis tsuas yog txhim kho cov tswv yim kho mob uas twb muaj lawm tab sis kuj tseem muab lub hauv paus rau kev tsim kho tshiab hom phiaj kho mob. Kev sim thoob ntiaj teb ntau qhov chaw kho mob, xws li I-SPY2 platform, hloov kho cov phiaj xwm kho mob raws li kev hloov pauv molecular pom hauv kev kuaj ntshav thaum ntxov, ua kom muaj cov tshuaj kho tus kheej tiag tiag.
Kev tshuaj xyuas thiab kev tswj xyuas kev tiv thaiv rau cov neeg muaj kev pheej hmoo siab -
Kev saib xyuas lub mis rau cov poj niam uas muaj kev pheej hmoo ntawm noob caj noob ces yuav tsum muaj cov txheej txheem rhiab ntau dua thiab qis dua qhov pib ntawm biopsy. Cov neeg nqa khoom ntawm BRCA1/2 kev hloov pauv muaj qhov pheej hmoo mob qog noj ntshav hauv lub neej ntawm 50-85%, nrog rau qhov pib ntxov thiab qog nqaij hlav sai. Kev soj ntsuam rau cov poj niam no yuav tsum pib thaum muaj hnub nyoog 25-30 xyoo, nrog rau kev hloov pauv mis MRI thiab mammography txhua rau lub hlis. Kev kuaj pom tsis zoo thaum kuaj xyuas-tsis hais qhov loj me lossis cov yam ntxwv atypical- feem ntau yog tswj hwm nrog kev kuaj ntshav sai, vim tias kev kuaj mob qeeb tuaj yeem cuam tshuam rau kev kuaj mob.
Lub mis ceev yog txuam nrog kev pheej hmoo mob qog noj ntshav thiab cuam tshuam rau kev txiav txim siab biopsy. Cov poj niam uas muaj lub mis tuab (BI-RADS pawg C thiab D) muaj 2 mus rau 4 npaug ntawm kev pheej hmoo mob qog noj ntshav siab dua piv rau cov mis fatty (qeb A), thiab mammographic rhiab heev. Lwm txoj kev tshuaj ntsuam xyuas ntxiv xws li ultrasound lossis MRI yog qhov tseem ceeb dua rau cov poj niam no, thiab cov kab mob uas tau kuaj pom yuav tsum muaj qhov tsawg dua kev kuaj ntshav. Cov kab mob uas tau txheeb xyuas los ntawm kev kuaj xyuas lub mis automated ultrasound yuav tsum raug txiav txim siab rau kev kuaj ntshav yog tias lawv pom muaj cov yam ntxwv tsis txaus ntseeg (xws li, cov duab tsis zoo, tsis yog- kev taw qhia sib luag, tom qab acoustic shadowing), txawm tias mammography tsis zoo.
Kev tswj cov tswv yim rau lobular carcinoma nyob rau hauv situ (LCIS) thiab atypical ductal hyperplasia (ADH) yog raws li cov txiaj ntsig ntawm cov koob txhaj tshuaj. Cov kab mob no lawv tus kheej tsis yog mob qog noj ntshav, tab sis lawv qhia tias muaj kev pheej hmoo ntawm mob qog noj ntshav mis (7- txog 10-fold siab dua rau LCIS thiab 4- mus rau 5-fold siab dua rau ADH). Tom qab ua tiav kev txiav tawm ntawm lub tshuab nqus tsev-pab biopsy, kev tshem tawm kev phais yuav raug zam, txawm tias yuav tsum tau saib xyuas ze. Kev saib xyuas suav nrog kev soj ntsuam cov duab txhua txhua 6 txog 12 lub hlis rau tsawg kawg 5 xyoos. Kev pheej hmoo-txo cov tswv yim xws li tamoxifen therapy yuav raug txiav txim siab, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas muaj kab mob multifocal lossis lwm yam kev pheej hmoo ntxiv.
Biopsy ntawm txiv neej lub mis txawv txav yuav tsum tau txiav txim siab tshwj xeeb. Txiv neej mob qog noj ntshav muaj txog 1% ntawm tag nrho cov qog nqaij hlav hauv lub mis tab sis feem ntau raug kuaj pom nyob rau theem tom qab thiab muaj qhov tsis zoo. Tus txiv neej lub mis muaj cov qog nqaij hlav tsawg, ua rau qhov txhab tau yooj yim palpable tab sis feem ntau tsis pom. Ib qho kev txawv txav ntawm mammographic lossis palpable loj nyob rau hauv tus txiv neej lub mis yuav tsum ua kom biopsy, tshwj xeeb tshaj yog thaum nrog cov tawv nqaij hloov, lub txiv mis tawm, los yog axillary lymphadenopathy. Kev siv mis biopsy hauv cov txiv neej zoo ib yam li cov poj niam siv, tab sis kev saib xyuas yuav tsum tau ua vim lub mis me me, qhov chaw phais tsawg, thiab xav tau kom meej meej hauv zos.
Breast biopsies in adolescents and young women require special caution. Breast masses in women under 30 are predominantly benign (>80%), tab sis mob qog noj ntshav mis tuaj yeem tshwm sim thiab feem ntau ua rau mob hnyav dua. Qhov kev txiav txim siab los ua ib qho biopsy yuav tsum sib npaug qhov xav tau rau kev kuaj mob uas muaj peev xwm cuam tshuam rau kev tsim cov ntaub so ntswg ntawm lub mis. Fine-Koob aspiration los yog core needle biopsy yuav tsum nyiam tshaj qhov kev phais biopsy kom txo tau caws pliav thiab mis deformation. Rau qhov xav tias phyllodes qog los yog cov kab mob lobulated, cov qauv yuav tsum nruj dua, vim tias cov qog no feem ntau tshwm sim hauv cov poj niam hluas thiab tuaj yeem loj hlob sai.
Cov tswv yim ntawm tus kheej rau cov xwm txheej tshwj xeeb
Biopsy ntawm lub mis txawv txav thaum cev xeeb tub thiab lactation yuav tsum tau hloov kho rau cov qauv kev cai. Cev xeeb tub- mob qog noj ntshav muaj feem cuam tshuam tshwm sim hauv kwv yees li 1 ntawm 3,000 tus poj niam cev xeeb tub thiab feem ntau kuaj pom lig. Ultrasound yog qhov kev xaiv zoo tshaj plaws vim nws tsis muaj hluav taws xob raug. Biopsy muaj kev nyab xeeb thiab ua tau, nrog lidocaine, tshuaj loog hauv zos, suav tias muaj kev nyab xeeb rau kev siv thaum cev xeeb tub. Core needle biopsy yog qhov zoo dua los ua kom zoo -koob aspiration, vim nws muab kev kuaj pom tseeb dua. Yog tias kev taw qhia mammography yog qhov tsim nyog, kev tiv thaiv kab mob plab yuav txo qis cov hluav taws xob ntawm tus menyuam hauv plab mus rau qib tsis txaus (<0.01 mGy). Breast biopsies during lactation should be performed after breastfeeding or milk expression to minimize interference from milk secretion.
Biopsy nyob rau hauv cov poj niam nrog lub mis cog yuav tsum tau tshwj xeeb kev txiav txim siab. Kev cog qoob loo tuaj yeem cuam tshuam rau cov duab zoo thiab kev npaj kho mob biopsy. Ultrasound pom meej meej pom cov nqaij ntshiv sab hauv ntawm qhov cog tab sis muaj peev xwm txwv tsis pub ntsuas cov ntaub so ntswg tom qab. Mammography siv cov kev pom kev hloov chaw (Eklund cov txheej txheem) los txhim kho kev pom ntawm cov ntaub so ntswg tom qab cog. MRI yog txoj hauv kev zoo tshaj plaws rau kev ntsuas kev cog qoob loo thiab cov ntaub so ntswg ib puag ncig. Cov kab mob biopsy yuav tsum zam qhov kev cog qoob loo, feem ntau yog siv lateral los yog superior koob nkag. Yog tias qhov mob nyob ib sab ntawm qhov cog, cov kua dej aspiration nyob rau hauv ultrasound lossis MRI kev taw qhia yuav tsim nyog los tsim qhov chaw phais.
Biopsy ntawm qhov chaw irradiated yav dhau los yuav tsum tau xav txog kev hloov cov ntaub so ntswg. Kev kho hluav taws xob tom qab lub mis-kev txuag kev phais ua rau muaj fibrosis thiab txo cov vascularity, uas yuav cuam tshuam rau kev kho mob thiab ua rau muaj kev pheej hmoo kis mob. Txawm hais tias txoj kev pheej hmoo los ntshav hauv cov cheeb tsam no tsawg, qhov kev pheej hmoo ntawm kev kis kab mob tuaj yeem nce siab, yuav tsum tau siv cov txheej txheem aseptic nruj. Hloov cov ntaub so ntswg kev ntxhib los mos tuaj yeem cuam tshuam cov qauv zoo, xav tau cov qauv loj dua. Biopsy yuav tsum tau zam nyob rau hauv cov cheeb tsam uas muaj hluav taws xob -induced dermatitis los yog rwj; Hloov chaw, rab koob yuav tsum tau muab tso rau hauv daim tawv nqaij noj qab nyob zoo. Yog tias tsim nyog, biopsy yuav tsum tau muab tshuaj tua kab mob prophylactic, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob immunocompromised.
Kev tswj kev pheej hmoo rau biopsy hauv cov neeg mob nrog coagulopathy. Cov neeg mob noj cov tshuaj tiv thaiv coagulants (warfarin, cov tshuaj tiv thaiv qhov ncauj tshiab, cov tshuaj tiv thaiv kab mob) muaj kev pheej hmoo los ntshav, tab sis feem ntau biopsies tuaj yeem ua tau zoo. Kev pheej hmoo los ntshav thaum lub sij hawm core needle biopsy yog tswj tau thaum lub thoob ntiaj teb normalized piv (INR) tsawg dua 3.0. Rau cov tshuaj anticoagulants tshiab ntawm qhov ncauj (xws li dabigatran, rivaroxaban), yuav tsum tau hloov kho raws li lub raum ua haujlwm thiab lub sijhawm txij li koob tshuaj kawg. Lub sijhawm ntev compression rau 15-20 feeb tom qab kev kuaj ntshav pom zoo, nrog rau cov tshuaj hemostatic xws li gelatin daim txhuam cev lossis thrombin. Hauv cov neeg mob uas muaj coagulopathy hnyav, zoo - koob aspiration tej zaum yuav raug suav hais tias yog lwm txoj hauv kev rau cov koob txhaj tshuaj.
Daim ntawv thov kev kho mob ntawm lub mis biopsy koob txuas mus deb tshaj qhov tau txais cov ntaub so ntswg kuaj. Nws ua haujlwm ua tus choj txuas cov duab tshawb pom nrog kev ntsuam xyuas kab mob, lub qhov rais rau kev soj ntsuam cov lus teb kho mob, lub cuab yeej rau kev tswj hwm cov neeg muaj kev pheej hmoo siab -, thiab lub hauv paus rau kev txiav txim siab tus kheej- ua hauv cov xwm txheej tshwj xeeb. Nrog rau kev nce qib ntawm cov tshuaj precision, biopsies tau hloov zuj zus los ntawm cov cuab yeej kuaj mob yooj yim mus rau hauv ntau lub platform qhia kev kho mob, kwv yees kwv yees, thiab txhawb kev tshawb fawb lom. Txhua tus txheej txheem biopsy tsis yog ib qho kev ua haujlwm nkaus xwb tab sis kuj yog qhov kev xav ntawm kev soj ntsuam kev txawj ntse- ntsuas cov txiaj ntsig kev kuaj mob nrog cov neeg mob txaus ntshai, nrhiav qhov tseeb ntawm qhov tsis paub tseeb, thiab muab txhua tus poj niam txoj kev saib xyuas tsim nyog tshaj plaws raws li nws cov kev xav tau.