• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Fine needle aspirating and cutting is superior to Tru-cut core needle in liver biopsy

    2013-06-01 12:24:36

    Shanghai, China

    Fine needle aspirating and cutting is superior to Tru-cut core needle in liver biopsy

    Guo-Ping Li, Gao-Quan Gong, Xiao-Lin Wang, Yi Chen, Jie-Min Cheng and Chang-Yu Li

    Shanghai, China

    BACKGROUND:Liver biopsy is the "gold standard" for evaluating liver disorders, but controversies over the potential risk of complications and patient discomfort still exist. Using a 21G fi ne needle, we developed a new biopsy procedure, fi ne needle aspirating and cutting (FNAC). Our procedure obtains enough tissue for pathological examination and meanwhile, reduces the risk of biopsy complications. The present study was to determine the safety and eff i ciency of 21G FNAC compared with 18G Tru-cut core needle (TCN) in liver tumor biopsies.

    METHODS:Ninety-four patients with unresectable malignant tumors were included in this study. Patients were divided into 2 groups: 18G TCN and 21G FNAC. The total positive rate (TPR) and safety of both groups were compared.

    RESULTS:TPR was not different between the two groups. Liver puncture track subcapsular hemorrhage and arteriovenous shunt were reported with 18G TCN but not with 21G FNAC. The incidence of pain caused by biopsy was higher for the 18G TCN group compared to the 21G FNAC group (P<0.05). About 82.6% of the patients in the 18G TCN group had a sample length >0.5 cm, but 52.1% in the 21G FNAC group (P<0.05). More than 50% of patients in both groups had suff i cient tissue for immunohistochemical examination.

    CONCLUSIONS:TPR is not different between the 21G FNAC and 18G TCN biopsy procedures, but the safety of 21G FNAC is superior to that of 18G TCN. Tissues obtained by either of these two procedures are suff i cient for a pathological diagnosis.

    (Hepatobiliary Pancreat Dis Int 2013;12:508-511)

    biopsy;tumor; chemoembolization; diagnostic; liver

    Introduction

    Percutaneous liver biopsy is one of the most important and widely used methods for the diagnosis of liver diseases and considered as the most specif i c method to assess the nature, the grade and the stage of certain liver diseases[1,2]and therefore, it is regarded as the "gold standard". Liver biopsy is more reliable than noninvasive modalities. Bialecki et al[3]recommended a greater role for image-guided biopsy of lesions greater than 1 cm that are clinically suspicious for HCC, in order to allow for adequate treatment planning, because the risks of biopsy appear small and the potential benef i ts are signif i cant. However, controversies related to the potential risk of complications and patient discomfort still exist.[4-6]

    To pathologists, a suff i cient biopsy tissue sample length is one of the most important factors in obtaining a reliable pathological diagnosis. Guido and Rugge[7]integrated previous and more recent data, and found that a biopsy sample length of 2 cm that contains at least 11 complete portal tracts should be suff i cient for reliable grading and staging of chronic viral hepatitis. Kugelmas[8]suggested that a reliable sample should be at least 2.5 cm in length, but approximately 3 entries into the tumor tissue are required to obtain this length, which increases the risk of bleeding. More punctures mean a higher rate of bleeding after the procedure. Szymczak and colleagues[4]retrospectively analyzed 1412 percutaneous liver biopsies, and 259 (18.3%) of them had complications, of which pain was the most common one (15.3%). Nine serious biopsy-related complications showed hemorrhage, hemothorax and biliary peritonitis. But there was no liver biopsy-associated fatality. Huang et al[9]reported that the bleeding rate after biopsy was about 0.32%; Own et al[10]reported that the main percutaneous liver biopsy complications were bleeding, bile leakage, hemothorax, and abdominal organ perforation, and that the overall incidence and mortality rates were approximately 3.2% and 0.01% to 0.1%, respectively.

    The development of immunohistochemistry allowedfor a more accurate diagnosis with less tissue. It is not known whether enough tissue can be obtained from tumors using a 21G fi ne needle. We developed a new biopsy procedure using a 21G fi ne needle, which we called fi ne needle aspirating and cutting (FNAC), to obtain enough tissues and meanwhile, to reduce complications. This study aimed to determine the safety and eff i ciency of 21G FNAC and to compare FNAC with 18G Tru-cut core needle (TCN) in tumor biopsies.

    Methods

    The study population comprised 94 patients (69 males and 25 females, aged 18 to 74 years) diagnosed with malignant tumors using CT/MRI or other tumor biomarkers. All of the tumors were unresectable and transarterial chemoembolization (TACE) was planned for palliative treatment. All patients were hospitalized in the Department of Interventional Radiology, Zhongshan Hospital, Fudan University from January 2009 to December 2011. To prepare for the procedure, a coagulation parameter assessment, blood morphology tests, liver and kidney function tests, and a chest X-ray were performed. The liver function grade (Child-Pugh classif i cation) was also assessed, and patients who had a Child-Pugh grade of "C" were excluded. This study was approved by the Ethics Committee of Zhongshan Hospital, Fudan University. All patients gave informed consent before the liver biopsy.

    Patients were divided into 2 groups: 18G TCN (Trucut core needle, COOK, USA,n=46) and 21G FNAC (f i ne needle aspirating and cutting, HAKKO, Japan,n=48). A 2% lidocaine solution was administered for local anesthesia. In some cases, intramuscular diazepam was administered as premedication. An arterial angiography was performed before every liver biopsy, and the catheter was placed in a liver tumor artery. All biopsies were punctured transhepatically and guided by B-ultrasound (BUS). Every biopsy in the 18G TCN group was completed with an 18G TCN. All biopsies were performed by skillful senior physicians with more than 4 years of experience in manipulating and diagnosing of BUS. In the FNAC group, a 21G fi ne needle was used to puncture into the targeted mass, and then the inner stylet was pulled out. The core needle was pushed and pulled 3-5 times in the targeted mass so that the tumor tissues were cut off and fi lled the needle core. At the same time, a negative pressure was maintained by a syringe concatenated with the needle. All tissues and puncture fl uids underwent pathological and cytological examination. After biopsy, another arterial angiography was carried out to roll out bleeding in needle tracks. TACE was performed according to the patient's situation. The needle was sterilized using an absolute alcohol gauze before every repeated puncture into the same patient's lesion. After the procedure, the patient's vital signs were closely monitored and symptomatic and supportive treatments were given. A visual analogue scale (VAS) was applied in assessing post-biopsy pain. Analgesia was administrated to patients according to the intensity of pain. After recovered, the patients were discharged and followed as outpatients.

    Data collected from archived medical documentation included age, sex, tumor biomarkers, laboratory test results, complications and outcomes, success of procedures, results of histological or cytological tissue sample evaluation, and records of biopsy processes. Assessing the procedure success and obtaining a representative sample was based on the pathologist's experience.

    Statistical analysis

    Statistical analysis was made using the SPSS 13.0 package (SPSS Inc., Chicago, IL, USA). The biopsy total positive rate (TPR) was obtained by counting the number of positive histological and cytological examinations. The TPR and the safety of both groups were statistically analyzed and compared. All samples were evaluated by a single pathologist. The Chi-square test and Student'sttest were used for statistical analysis. APvalue of <0.05 was considered statistically signif i cant.

    Results

    No signif i cant difference was noted in gender, mean age and tumor diameter between the 18G TCN and 21G FNAC groups (P>0.05, Table 1). All biopsy procedures were completed successfully. All tumors were diagnosed as malignant. The 18G TCN TPR was 89.1% and the 21G FNAC TPR was 81.3%; there was no statistically signif i cant difference in the TPRs between the two groups (P>0.05, Table 2).

    Table 1.Demographics of patients

    About 82.6% (38/46) of sample's length was greater than 0.5 cm in the 18G TCN group, while 52.1% (25/48) in the 21G FNAC group. Forty (87.0%) of the samples in the 18G TCN group and 36 (75.0%) in the 21G FNAC group are enough for immunohistochemistry. Hepatocellular carcinoma was the main pathologic type in more than 50% of these patients. Broken cellular structure was the main reason for negative results in the 21G FNAC group, and other negative results included inf l ammatory lesions, necrotic tissue, sludged blood, and liver tissue (Table 2).

    The incidence rate of liver puncture track subcapsular hemorrhage (according to arterial angiography) and an arteriovenous shunt (A-V shunt) incidence rate was 6.5% (3/46) and 8.7% (4/46) in the 18G TCN group, while there were no detectable hemorrhage and A-V shunt in the 21G FNAC group. The incidence of pain (VAS≥1) caused by biopsy was 78.3% (36/46) in the 18G TCN group and 22.9% (11/48) in the 21G FNAC group. The average VAS score in the 21G FNAC group was signif i cantly lower than that in the 18G TCN group (0.3 ± 0.6 vs 1.2±0.7). All patients felt slight pain (VAS<3) atpuncture points and recovered 2 to 3 days later without analgesia or intervention. No patient in either group suffered from pneumothorax, pleural effusion, and peritonitis, or had severe complications such as massive bleeding or exsanguine shock. No tumor implantation was found in puncture tracks in any patient after 3 months of follow-up (Table 3).

    Table 2.Pathological diagnosis of 94 patients with liver masses (n, %)

    Table 3.Liver biopsy complications in the two groups (n, %)

    Discussion

    Many studies in the last decade evaluated the safety and risk of complications in liver biopsy.[11-13]The patients analyzed varied in indications, underlying conditions, methods, needles used, and guiding techniques. These studies demonstrated that percutaneous liver biopsy is commonly accepted as an eff i cient and safe way to diagnose liver masses. However, because biopsy is an invasive method, there are inevitable risks of complications.[14-17]These complications can be reduced by using currently available instruments and by choosing a proper process. New biopsy procedures need to be developed in order to minimize complications and to increase biopsy eff i ciency.

    Currently, the 18G TCN is used most commonly in liver biopsy and it has shown a high degree of safety and eff i ciency. However, an 18G needle can cause bleeding especially in the aff l uent blood supply or perivascular masses. In patients with Chilaiditi syndrome, a liver biopsy should avoid puncturing the colon, a thin biopsy needle is preferred. When the lesions are deep-seated or close to vital structures, such as pancreatic cancer, retroperitoneal tumor or mediastinal masses, a thick needle with a diameter of more than 18G means a greater risk of bleeding and of other complications.[18-20]Fine needle aspiration (FNA) is safer for these tumors, but the tissues obtained from FNA are usually only suitable for cytological examination.[21]FNAC may partially resolve the above-mentioned drawbacks of 18G TCN and FNAC. A core fi ne needle, by "pushing and pulling", cut off the tissue and left a cavity behind. If the needle punctures throughout the tumor, there is a chance of obtaining the tissue from the whole puncture track. Additionally, if the fi ne needle is punctured into the tumor for 3-5 times at different angles, enough tissue may be obtained for histology.

    TPR did not reach signif i cant difference between the two groups which implied that the eff i ciency of 21G FNAC was similar to that of 18G TCN. Furthermore, tissues obtained by 21G FNAC were comparable to those by 18G TCN in term of immunohistochemical staining, suggesting that 21G FNAC could harvest enough tissue for a pathological diagnosis as did 18G TCN. In termsof tissue length, 18G TCN is superior to 21G FNAC. However, less complication may compensate this shortness: no hemorrhage and A-V shunts in the 21G FNAC group, while 8.7% (4/46) of 18-TCN patients had A-V shunts and 6.5% (3/46) subcapsular hemorrhage. The pain complaint (VAS≥1) rate was signif i cantly lower in the 21G FNAC group than that in the 18G TCN group. The biopsy needle diameter is an important factor in causing complications, and the results of this study suggest that 21G FNAC is safer than 18G TCN.

    The operator's experience and skill plays an important role in the safety and the success rate of liver biopsy.[22,23]In our study, all biopsies were performed by senior physicians who were skillful at BUS. During FNAC procedure, the actions of "pushing and pulling" were guided under ultrasonography. The cutting speed and force power could be controlled well by a skillful operator, and therefore, complications could be reduced.

    We also found some drawbacks of FNAC: less tissue for histology, especially when the tumors were hard or rich in connective tissues; blood clots in the sample could also disturb the examination results.

    In conclusion, tissues obtained using either of 21G FNAC or 18G TCN in liver biopsy are enough for a pathological diagnosis. There is no statistical difference in the TPR between the two biopsy procedures. However, the safety of 21G FNAC may be superior to that of 18G TCN biopsy.

    Contributors:GGQ and WXL proposed the study. LGP wrote the fi rst draft. LGP and GGQ collected and analyzed the data. All authors contributed to the design and interpretation of the study and to further drafts. GGQ is the guarantor.

    Funding:This study was supported by a grant from the Project of Shanghai Health Bureau (2010022).

    Ethical approval:This study was approved by the Ethics Committee of Zhongshan Hospital, Fudan University (2010-105).

    Competing interest:No benef i ts in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

    1 Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med 2001;344:495-500.

    2 Campbell MS, Reddy KR. Review article: the evolving role of liver biopsy. Aliment Pharmacol Ther 2004;20:249-259.

    3 Bialecki ES, Ezenekwe AM, Brunt EM, Collins BT, Ponder TB, Bieneman BK, et al. Comparison of liver biopsy and noninvasive methods for diagnosis of hepatocellular carcinoma. Clin Gastroenterol Hepatol 2006;4:361-368.

    4 Szymczak A, Simon K, Inglot M, Gladysz A. Safety and effectiveness of blind percutaneous liver biopsy: analysis of 1412 procedures. Hepat Mon 2012;12:32-37.

    5 West J, Card TR. Reduced mortality rates following elective percutaneous liver biopsies. Gastroenterology 2010;139:1230-1237.

    6 Younossi ZM, Teran JC, Ganiats TG, Carey WD. Ultrasoundguided liver biopsy for parenchymal liver disease: an economic analysis. Dig Dis Sci 1998;43:46-50.

    7 Guido M, Rugge M. Liver biopsy sampling in chronic viral hepatitis. Semin Liver Dis 2004;24:89-97.

    8 Kugelmas M. Liver biopsy. Am J Gastroenterol 2004;99:1416-1417.

    9 Huang JF, Hsieh MY, Dai CY, Hou NJ, Lee LP, Lin ZY, et al. The incidence and risks of liver biopsy in non-cirrhotic patients: An evaluation of 3806 biopsies. Gut 2007;56:736-737.

    10 Own A, Balzer JO, Vogl TJ. Bleeding hepatic pseudoaneurysm complicating percutaneous liver biopsy with interventional treatment options. Eur Radiol 2005;15:183-185.

    11 Bateson MC, Hopwood D, Duguid HL, Bouchier IA. A comparative trial of liver biopsy needles. J Clin Pathol 1980; 33:131-133.

    12 Lindor KD, Bru C, Jorgensen RA, Rakela J, Bordas JM, Gross JB, et al. The role of ultrasonography and automatic-needle biopsy in outpatient percutaneous liver biopsy. Hepatology 1996;23:1079-1083.

    13 de Man RA, van Buuren HR, Hop WC. A randomised study on the eff i cacy and safety of an automated Tru-Cut needle for percutaneous liver biopsy. Neth J Med 2004;62:441-445.

    14 Colombo M, Del Ninno E, de Franchis R, De Fazio C, Festorazzi S, Ronchi G, et al. Ultrasound-assisted percutaneous liver biopsy: superiority of the Tru-Cut over the Menghini needle for diagnosis of cirrhosis. Gastroenterology 1988;95:487-489.

    15 Pasha T, Gabriel S, Therneau T, Dickson ER, Lindor KD. Costeffectiveness of ultrasound-guided liver biopsy. Hepatology 1998;27:1220-1226.

    16 Songür N, Songür Y, Bircan S, Kapucuo?lu N. Comparison of 19- and 22-gauge needles in EUS-guided fi ne needle aspiration in patients with mediastinal masses and lymph nodes. Turk J Gastroenterol 2011;22:472-478.

    17 Amin Z, Theis B, Russell RC, House C, Novelli M, Lees WR. Diagnosing pancreatic cancer: the role of percutaneous biopsy and CT. Clin Radiol 2006;61:996-1002.

    18 Cavanna L, Lazzaro A, Vallisa D, Civardi G, Artioli F. Role of image-guided fi ne-needle aspiration biopsy in the management of patients with splenic metastasis. World J Surg Oncol 2007;5:13.

    19 Swischuk JL, Castaneda F, Patel JC, Li R, Fraser KW, Brady TM, et al. Percutaneous transthoracic needle biopsy of the lung: review of 612 lesions. J Vasc Interv Radiol 1998;9:347-352.

    20 Thanos L, Zormpala A, Papaioannou G, Malagari K, Brountzos E, Kelekis D. Safety and eff i cacy of percutaneous CT-guided liver biopsy using an 18-gauge automated needle. Eur J Intern Med 2005;16:571-574.

    21 B?cking A. Cytological vs histological evaluation of percutaneous biopsies. Cardiovasc Intervent Radiol 1991;14:5-12.

    22 van der Poorten D, Kwok A, Lam T, Ridley L, Jones DB, Ngu MC, et al. Twenty-year audit of percutaneous liver biopsy in a major Australian teaching hospital. Intern Med J 2006;36: 692-699.

    23 Froehlich F, Lamy O, Fried M, Gonvers JJ. Practice and complications of liver biopsy. Results of a nationwide survey in Switzerland. Dig Dis Sci 1993;38:1480-1484.

    Received August 30, 2012

    Accepted after revision January 15, 2013

    AuthorAff i liations:Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China (Li GP, Gong GQ, Wang XL, Chen Y, Cheng JM and Li CY)

    Gao-Quan Gong, MD, Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China (Fax: 86-21-64037258; Email: gong.gaoquan@zs-hospital.sh.cn)

    ? 2013, Hepatobiliary Pancreat Dis Int. All rights reserved.

    10.1016/S1499-3872(13)60080-6

    精品欧美国产一区二区三| 国产男靠女视频免费网站| 日韩欧美三级三区| 免费人成视频x8x8入口观看| 桃色一区二区三区在线观看| 少妇的逼水好多| 两个人的视频大全免费| 亚洲自偷自拍三级| 久9热在线精品视频| 国产又黄又爽又无遮挡在线| 精品不卡国产一区二区三区| 18禁黄网站禁片免费观看直播| or卡值多少钱| 日本黄色片子视频| 特级一级黄色大片| 日本色播在线视频| 国内毛片毛片毛片毛片毛片| 久久久久性生活片| 成人永久免费在线观看视频| 一级a爱片免费观看的视频| 狂野欧美激情性xxxx在线观看| 国产真实乱freesex| 九色国产91popny在线| .国产精品久久| 久久亚洲精品不卡| 99riav亚洲国产免费| 欧洲精品卡2卡3卡4卡5卡区| 波野结衣二区三区在线| 久久中文看片网| 99久久无色码亚洲精品果冻| 欧洲精品卡2卡3卡4卡5卡区| 全区人妻精品视频| 亚洲国产欧洲综合997久久,| 精品欧美国产一区二区三| 日本一本二区三区精品| 中文亚洲av片在线观看爽| 他把我摸到了高潮在线观看| 久久午夜亚洲精品久久| 人妻丰满熟妇av一区二区三区| 在线天堂最新版资源| 国产高清激情床上av| 亚洲aⅴ乱码一区二区在线播放| 亚洲精品456在线播放app | 欧美激情在线99| 中出人妻视频一区二区| 不卡视频在线观看欧美| 亚洲精品成人久久久久久| 一级毛片久久久久久久久女| 欧美极品一区二区三区四区| 亚洲精华国产精华液的使用体验 | 免费无遮挡裸体视频| 美女免费视频网站| 91在线精品国自产拍蜜月| 又爽又黄无遮挡网站| 欧美日韩国产亚洲二区| 欧美bdsm另类| 啪啪无遮挡十八禁网站| 国产在视频线在精品| 国产高清不卡午夜福利| 久久这里只有精品中国| 日韩av在线大香蕉| 免费看日本二区| 欧美绝顶高潮抽搐喷水| 久久精品国产亚洲av香蕉五月| 91久久精品国产一区二区成人| 亚洲欧美精品综合久久99| 国内精品一区二区在线观看| 日日撸夜夜添| 久9热在线精品视频| 亚洲男人的天堂狠狠| 免费看光身美女| 日韩中字成人| 久久久久国内视频| 一本精品99久久精品77| ponron亚洲| 琪琪午夜伦伦电影理论片6080| 午夜精品久久久久久毛片777| 成人综合一区亚洲| 亚洲真实伦在线观看| 免费大片18禁| 国产精品永久免费网站| 国产精品一区二区性色av| 少妇的逼好多水| 精品人妻熟女av久视频| 国产精品人妻久久久久久| 久久久午夜欧美精品| 免费看美女性在线毛片视频| 国产精品久久电影中文字幕| 欧美日韩黄片免| 欧美精品国产亚洲| 午夜激情福利司机影院| 日韩欧美在线乱码| av.在线天堂| www.色视频.com| 日韩强制内射视频| 亚洲国产色片| 欧美+日韩+精品| 婷婷色综合大香蕉| 亚洲av免费高清在线观看| 国产探花在线观看一区二区| 日本色播在线视频| 男人的好看免费观看在线视频| 精品久久久噜噜| 国产高潮美女av| 亚洲最大成人av| 女人被狂操c到高潮| 日韩,欧美,国产一区二区三区 | 日日夜夜操网爽| 大型黄色视频在线免费观看| 日韩av在线大香蕉| 久久久久久久亚洲中文字幕| 91午夜精品亚洲一区二区三区 | 亚洲精品一卡2卡三卡4卡5卡| 香蕉av资源在线| 在现免费观看毛片| 看黄色毛片网站| 午夜影院日韩av| 岛国在线免费视频观看| 男女那种视频在线观看| 中文字幕av成人在线电影| 国产精品日韩av在线免费观看| 非洲黑人性xxxx精品又粗又长| 尾随美女入室| 99久久中文字幕三级久久日本| 亚洲四区av| 国产欧美日韩精品一区二区| 国产不卡一卡二| 97热精品久久久久久| 久久久久久久亚洲中文字幕| 亚洲自拍偷在线| 欧美黑人巨大hd| 国产高清三级在线| 国产三级在线视频| 国产精品久久视频播放| 淫妇啪啪啪对白视频| 国产爱豆传媒在线观看| 成人午夜高清在线视频| 啦啦啦观看免费观看视频高清| 日韩一本色道免费dvd| 我要搜黄色片| 日韩大尺度精品在线看网址| 少妇人妻一区二区三区视频| 日本欧美国产在线视频| 特级一级黄色大片| 十八禁网站免费在线| 51国产日韩欧美| 国产免费男女视频| 99热只有精品国产| 麻豆精品久久久久久蜜桃| 国产毛片a区久久久久| 久久久久久伊人网av| 麻豆成人午夜福利视频| 亚洲av五月六月丁香网| 男女边吃奶边做爰视频| 老司机午夜福利在线观看视频| 黄色日韩在线| 综合色av麻豆| 男女那种视频在线观看| 美女免费视频网站| 亚洲最大成人手机在线| 麻豆一二三区av精品| 日本色播在线视频| 国产美女午夜福利| 女同久久另类99精品国产91| 深爱激情五月婷婷| 男女那种视频在线观看| 色在线成人网| 亚洲欧美清纯卡通| 中国美白少妇内射xxxbb| 色噜噜av男人的天堂激情| 午夜福利视频1000在线观看| 色综合婷婷激情| 少妇丰满av| 99久久精品国产国产毛片| 免费av观看视频| 国产一区二区在线观看日韩| 可以在线观看的亚洲视频| 久久精品国产亚洲av涩爱 | 18禁黄网站禁片免费观看直播| 俺也久久电影网| 少妇的逼水好多| 久久亚洲精品不卡| 久久99热6这里只有精品| 亚洲精品一卡2卡三卡4卡5卡| 精品久久久久久久久av| 亚洲图色成人| 婷婷精品国产亚洲av在线| 少妇猛男粗大的猛烈进出视频 | 级片在线观看| 亚洲精品日韩av片在线观看| 18禁黄网站禁片午夜丰满| 亚洲国产精品合色在线| 淫秽高清视频在线观看| 99热这里只有是精品50| 搡女人真爽免费视频火全软件 | 精品久久久久久成人av| 99国产极品粉嫩在线观看| 午夜福利在线观看吧| 人人妻人人看人人澡| 婷婷六月久久综合丁香| 欧美xxxx性猛交bbbb| 亚洲国产精品合色在线| 中文字幕熟女人妻在线| 国产色婷婷99| www日本黄色视频网| 亚洲最大成人手机在线| 熟妇人妻久久中文字幕3abv| 波多野结衣高清作品| 久久精品国产99精品国产亚洲性色| 亚洲成人免费电影在线观看| 国产高清有码在线观看视频| 人人妻人人看人人澡| 国产免费av片在线观看野外av| 国产亚洲精品综合一区在线观看| 黄色女人牲交| 久久草成人影院| 动漫黄色视频在线观看| 一区二区三区四区激情视频 | 精品人妻一区二区三区麻豆 | 他把我摸到了高潮在线观看| 极品教师在线视频| 国产精品久久久久久亚洲av鲁大| 国产亚洲精品久久久com| 不卡视频在线观看欧美| or卡值多少钱| 可以在线观看毛片的网站| 日韩精品有码人妻一区| 成年免费大片在线观看| 大型黄色视频在线免费观看| 国产精品嫩草影院av在线观看 | av在线天堂中文字幕| 午夜久久久久精精品| 最好的美女福利视频网| 欧美色视频一区免费| 亚洲欧美日韩东京热| 日韩欧美精品v在线| 亚洲国产精品成人综合色| 乱码一卡2卡4卡精品| 国产老妇女一区| 亚洲无线在线观看| 免费在线观看日本一区| 久久久久久久久大av| 桃色一区二区三区在线观看| 大型黄色视频在线免费观看| 好男人在线观看高清免费视频| 伦理电影大哥的女人| 国产一区二区在线av高清观看| 99热这里只有精品一区| 国产一区二区三区av在线 | 高清毛片免费观看视频网站| 老熟妇乱子伦视频在线观看| 日本爱情动作片www.在线观看 | 老熟妇仑乱视频hdxx| 国产精品久久久久久av不卡| 内射极品少妇av片p| 国产黄a三级三级三级人| 亚洲图色成人| 国产不卡一卡二| x7x7x7水蜜桃| 22中文网久久字幕| 麻豆国产av国片精品| 欧美绝顶高潮抽搐喷水| 最近视频中文字幕2019在线8| 国产综合懂色| 久久99热这里只有精品18| 欧美色欧美亚洲另类二区| 国内精品美女久久久久久| 亚洲国产精品成人综合色| 91在线观看av| 露出奶头的视频| 男女那种视频在线观看| 精品一区二区免费观看| 日韩欧美在线二视频| av中文乱码字幕在线| 国产精品嫩草影院av在线观看 | 国产伦人伦偷精品视频| 欧美高清成人免费视频www| 精品午夜福利在线看| 内地一区二区视频在线| 久久精品国产自在天天线| 51国产日韩欧美| 免费观看在线日韩| 桃红色精品国产亚洲av| 九九在线视频观看精品| 色精品久久人妻99蜜桃| 婷婷精品国产亚洲av| 欧美日韩乱码在线| 真人做人爱边吃奶动态| 男女边吃奶边做爰视频| 99精品在免费线老司机午夜| 国产私拍福利视频在线观看| av黄色大香蕉| 久久久成人免费电影| 久久精品国产99精品国产亚洲性色| 日韩人妻高清精品专区| 午夜爱爱视频在线播放| 亚洲成人免费电影在线观看| 性色avwww在线观看| 人妻制服诱惑在线中文字幕| 天美传媒精品一区二区| 内射极品少妇av片p| 久久久久久大精品| 波多野结衣巨乳人妻| 波多野结衣高清作品| 精品人妻一区二区三区麻豆 | 亚洲av成人av| 又黄又爽又刺激的免费视频.| 日本 av在线| 91精品国产九色| 日本五十路高清| 成人性生交大片免费视频hd| 国产免费一级a男人的天堂| 午夜老司机福利剧场| 又黄又爽又免费观看的视频| 日本免费a在线| 午夜日韩欧美国产| 中文字幕熟女人妻在线| 日韩在线高清观看一区二区三区 | 国产av一区在线观看免费| 亚洲精品成人久久久久久| 桃色一区二区三区在线观看| 村上凉子中文字幕在线| 久久久国产成人精品二区| 午夜福利在线在线| 国产视频内射| 色在线成人网| 老司机午夜福利在线观看视频| 人人妻人人澡欧美一区二区| 久久久久性生活片| 国产三级在线视频| 又爽又黄无遮挡网站| 国产男靠女视频免费网站| 欧美xxxx性猛交bbbb| 一区二区三区高清视频在线| 熟女人妻精品中文字幕| 嫩草影视91久久| 成人av在线播放网站| 亚洲一区二区三区色噜噜| 俺也久久电影网| 女同久久另类99精品国产91| 春色校园在线视频观看| 国产午夜福利久久久久久| 中国美女看黄片| 99久久九九国产精品国产免费| 俄罗斯特黄特色一大片| 伦精品一区二区三区| 国产精品精品国产色婷婷| 波多野结衣巨乳人妻| 国产一区二区在线av高清观看| 国产色婷婷99| 国国产精品蜜臀av免费| 午夜视频国产福利| 国产精品自产拍在线观看55亚洲| 在线播放无遮挡| 亚洲最大成人av| 国产精品人妻久久久久久| 91久久精品国产一区二区三区| 可以在线观看毛片的网站| 哪里可以看免费的av片| 天堂av国产一区二区熟女人妻| 国产黄a三级三级三级人| 国产探花在线观看一区二区| 琪琪午夜伦伦电影理论片6080| 国产欧美日韩精品一区二区| 亚洲无线在线观看| 亚洲无线观看免费| 在线观看美女被高潮喷水网站| netflix在线观看网站| 亚洲熟妇熟女久久| 99精品在免费线老司机午夜| 亚洲精品国产成人久久av| 天堂av国产一区二区熟女人妻| 女生性感内裤真人,穿戴方法视频| 欧美潮喷喷水| 国产精品爽爽va在线观看网站| 久久久久久久久中文| 国产精品爽爽va在线观看网站| 在线国产一区二区在线| 超碰av人人做人人爽久久| 欧美激情国产日韩精品一区| 岛国在线免费视频观看| 亚洲专区国产一区二区| 给我免费播放毛片高清在线观看| 精品一区二区三区人妻视频| 国产人妻一区二区三区在| 国产精品综合久久久久久久免费| 三级毛片av免费| 波多野结衣高清无吗| 婷婷精品国产亚洲av| 精品免费久久久久久久清纯| 国产黄片美女视频| 99久久精品国产国产毛片| 欧美日韩黄片免| av女优亚洲男人天堂| 国产免费一级a男人的天堂| 成人性生交大片免费视频hd| 午夜免费成人在线视频| 91精品国产九色| 男人舔女人下体高潮全视频| 一本精品99久久精品77| 97超视频在线观看视频| 国产伦精品一区二区三区四那| 亚洲国产欧美人成| 国产亚洲精品av在线| 免费观看人在逋| 欧美日韩瑟瑟在线播放| 欧美成人一区二区免费高清观看| 日本黄大片高清| 能在线免费观看的黄片| 国产精品福利在线免费观看| 成熟少妇高潮喷水视频| 色吧在线观看| 国产探花在线观看一区二区| 乱人视频在线观看| 国产精品国产高清国产av| 精品久久久久久久末码| 身体一侧抽搐| 免费在线观看成人毛片| 五月伊人婷婷丁香| 直男gayav资源| 久久精品国产清高在天天线| 窝窝影院91人妻| 我要看日韩黄色一级片| 亚洲国产精品合色在线| 18禁裸乳无遮挡免费网站照片| 国产午夜福利久久久久久| 午夜爱爱视频在线播放| 色在线成人网| 欧美国产日韩亚洲一区| 久久人人爽人人爽人人片va| 免费av观看视频| 一夜夜www| 国产精品98久久久久久宅男小说| 在现免费观看毛片| av天堂在线播放| 国产精品伦人一区二区| 久久99热这里只有精品18| 九色国产91popny在线| 国产精品一区二区三区四区久久| 国产亚洲精品综合一区在线观看| 欧美激情在线99| 精品不卡国产一区二区三区| 成人性生交大片免费视频hd| 国产一区二区三区av在线 | 久久精品国产99精品国产亚洲性色| 男人舔女人下体高潮全视频| 亚洲人成网站高清观看| 亚洲最大成人av| 亚洲欧美日韩东京热| 国模一区二区三区四区视频| 人妻夜夜爽99麻豆av| 一级黄片播放器| 日本色播在线视频| 国产aⅴ精品一区二区三区波| 亚洲熟妇中文字幕五十中出| 国产精品人妻久久久久久| а√天堂www在线а√下载| 国语自产精品视频在线第100页| 给我免费播放毛片高清在线观看| 日日啪夜夜撸| 欧美另类亚洲清纯唯美| 天堂动漫精品| 在线观看舔阴道视频| 午夜亚洲福利在线播放| 久久香蕉精品热| 可以在线观看的亚洲视频| 国产精品无大码| 国产精品永久免费网站| 女生性感内裤真人,穿戴方法视频| 亚洲,欧美,日韩| 一区二区三区免费毛片| 露出奶头的视频| 欧美+日韩+精品| 国产精品久久视频播放| 国内少妇人妻偷人精品xxx网站| 日本黄色片子视频| 99热网站在线观看| 午夜视频国产福利| 亚洲国产精品成人综合色| 午夜福利在线观看免费完整高清在 | 国产免费av片在线观看野外av| 成人综合一区亚洲| 国产伦人伦偷精品视频| 日本黄色视频三级网站网址| 国产中年淑女户外野战色| 日本色播在线视频| 亚洲av成人精品一区久久| 嫩草影院精品99| 亚洲av二区三区四区| 精品一区二区三区视频在线| 色在线成人网| 久久人妻av系列| 91久久精品国产一区二区三区| 又黄又爽又免费观看的视频| 亚洲欧美日韩高清专用| 91av网一区二区| 男女那种视频在线观看| 免费看美女性在线毛片视频| 在线天堂最新版资源| 国内精品久久久久久久电影| 热99在线观看视频| av专区在线播放| 岛国在线免费视频观看| 1000部很黄的大片| 特大巨黑吊av在线直播| 亚洲精品色激情综合| 色5月婷婷丁香| 性色avwww在线观看| 神马国产精品三级电影在线观看| 精品99又大又爽又粗少妇毛片 | 免费看光身美女| 99久久精品国产国产毛片| 最好的美女福利视频网| 国产综合懂色| 免费大片18禁| 成年女人看的毛片在线观看| 亚洲成a人片在线一区二区| 久久久久久伊人网av| 日韩欧美在线乱码| 97热精品久久久久久| 亚洲精品亚洲一区二区| 内地一区二区视频在线| 色综合站精品国产| 国产白丝娇喘喷水9色精品| 简卡轻食公司| 日韩中字成人| 国产av麻豆久久久久久久| 99国产精品一区二区蜜桃av| 欧美一区二区精品小视频在线| 亚洲欧美精品综合久久99| 国产男人的电影天堂91| 人妻制服诱惑在线中文字幕| 国产淫片久久久久久久久| www日本黄色视频网| 人妻丰满熟妇av一区二区三区| 精品免费久久久久久久清纯| 人妻夜夜爽99麻豆av| 欧美成人免费av一区二区三区| 长腿黑丝高跟| 欧美不卡视频在线免费观看| 国产真实乱freesex| 久久精品国产自在天天线| 窝窝影院91人妻| 啪啪无遮挡十八禁网站| 国产三级中文精品| 亚洲美女搞黄在线观看 | 99热这里只有是精品在线观看| 香蕉av资源在线| 久久久久免费精品人妻一区二区| 免费观看的影片在线观看| 国产真实伦视频高清在线观看 | 一级毛片久久久久久久久女| 精品一区二区三区视频在线观看免费| 亚洲精品456在线播放app | 日本熟妇午夜| 1024手机看黄色片| 一区福利在线观看| 亚洲中文日韩欧美视频| 性色avwww在线观看| 午夜福利18| 男女那种视频在线观看| 亚洲七黄色美女视频| 人妻夜夜爽99麻豆av| 欧美另类亚洲清纯唯美| 综合色av麻豆| 日本黄色视频三级网站网址| 国产v大片淫在线免费观看| 床上黄色一级片| 婷婷精品国产亚洲av| 国产日本99.免费观看| 亚洲一级一片aⅴ在线观看| 老司机深夜福利视频在线观看| 1024手机看黄色片| 国产主播在线观看一区二区| 日韩在线高清观看一区二区三区 | 国产黄片美女视频| aaaaa片日本免费| 88av欧美| 老熟妇乱子伦视频在线观看| 国内精品久久久久久久电影| 亚洲av免费在线观看| 亚洲国产精品合色在线| 午夜激情福利司机影院| 亚洲一级一片aⅴ在线观看| 免费看光身美女| 一进一出抽搐动态| 99久久中文字幕三级久久日本| 久久精品国产亚洲av涩爱 | 99久久精品国产国产毛片| 五月伊人婷婷丁香| 小蜜桃在线观看免费完整版高清| 一本久久中文字幕| 3wmmmm亚洲av在线观看| 午夜日韩欧美国产| 亚洲最大成人手机在线| 一区福利在线观看| 中文资源天堂在线| 亚洲av免费高清在线观看| 国内揄拍国产精品人妻在线| 欧美日本视频| 日本欧美国产在线视频| 精品国产三级普通话版| 色5月婷婷丁香| 别揉我奶头~嗯~啊~动态视频| 日韩欧美一区二区三区在线观看| 国产伦一二天堂av在线观看| 麻豆成人午夜福利视频| 一进一出好大好爽视频| 日本熟妇午夜| 一级黄片播放器| 亚洲国产欧洲综合997久久,| 亚洲av二区三区四区| 性欧美人与动物交配| 亚洲熟妇熟女久久| 国产视频一区二区在线看|