The Adequacy of Core Biopsy in the Assessment of Smooth Muscle Neoplasms of Soft Tissues: Implications for Treatment and Prognosis
The Adequacy of Core Biopsy in the Assessment of Smooth Muscle Neoplasms of Soft Tissues: Implications for Treatment and Prognosis
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DOI：
10.1097/pas.0000000000000867
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发表时间：
2017-07-01
影响因子：
5.6
通讯作者：
Thway, Khin
中科院分区：
文献类型：
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作者：
Schneider, Nina;Strauss, Dirk C.;Thway, Khin
软组织肉瘤的分级是最重要的预后因素之一，决定了患者的治疗。虽然大多数成人型软组织肉瘤的活检分级与切除标本的最终分级高度相关，但平滑肌肿瘤的分级似乎不太可靠。我们评估了我们三级肉瘤中心通过核心活检诊断的平滑肌肿瘤的病理表现，并将其与随后切除标本的病理表现进行了比较。共有100例平滑肌肉瘤患者首次诊断为核心活检并随后切除，并通过比较活检分级和切除分级来确定活检分级的准确性。其他显著组织学参数的差异也被注意到。在68%的平滑肌肉瘤病例中，活检标本和切除标本的级别存在差异，所有这些病例都显示从活检标本到切除标本的级别增加。在使用法国癌症中心联合会肉瘤组分级系统（FNCLCC）进行分级的3个参数中，坏死是活检和切除标本之间最常见的差异（55%），紧随其后的是有丝分裂计数（51%）。与其他成人软组织肉瘤相比，软组织平滑肌肿瘤活检分级的准确性较低，因此应谨慎对待，特别是因为这可能是真实肿瘤分级的不足代表。
The grading of soft tissue sarcomas is one of the most important prognostic factors and determines patient management. Although grading of most adult-type soft tissue sarcomas on biopsies correlates highly with the final grading on the excision specimen, it appears less reliable for tumors of smooth muscle. We assessed the pathologic findings for smooth muscle neoplasms diagnosed by core biopsy at our tertiary sarcoma center, and compared them with those in the subsequent excision specimens. A total of 100 patients with leiomyosarcoma first diagnosed on core biopsy and with a subsequent excision were identified and the accuracy of the biopsy grade determined by comparison with the excision grade. Differences in other salient histologic parameters were also noted. A grade difference between biopsy and excision specimens of leiomyosarcomas was found in 68% of cases, with all these cases showing an increase in grade from biopsy to excision specimen. Of the 3 parameters used for grading using the French Federation of Cancer Centers Sarcoma Group Grading System (FNCLCC), necrosis was the score that most commonly differed between biopsy and excision specimen (55%), closely followed by the mitotic count (51%). The grading of soft tissue smooth muscle tumor biopsies has a lower accuracy compared with other adult soft tissue sarcomas and should therefore be taken with caution, particularly as this may be an underrepresentation of the true tumor grade.