Accurate diagnosis of musculoskeletal lesions by core needle biopsy
Accurate diagnosis of musculoskeletal lesions by core needle biopsy
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DOI：
10.1002/jso.20504
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发表时间：
2006-07-01
影响因子：
2.5
通讯作者：
Ozaki, Toshifumi
中科院分区：
文献类型：
--
作者：
Mitsuyoshi, Goro;Naito, Noriko;Ozaki, Toshifumi
背景：经皮穿刺活检在治疗肿瘤方面比开放活检有许多优点。然而，针吸活检在诊断肌肉骨骼病变的准确性尚未建立。在此，我们评估该手术对肌肉骨骼病变的准确性和局限性。对157名连续患者使用Jamshidi针或Ostycut针进行骨病变检查，或使用Tru-cut针进行软组织病变检查，并与开放活检和/或明确手术的最终诊断进行比较。确定143份标本（88%）足以进行组织学检查。从非常硬的骨病变或骨质囊肿壁获得未受损的芯被证明是困难的。具有肌肉骨骼病变经验的病理学家能够在97%的病例中区分恶性肿瘤和良性病变（骨，100%;软组织，94%），并在获得足够的核心时在88%（骨，96%;软组织，78%）中达到特定诊断。鉴别高分化脂肪肉瘤和良性脂肪瘤，以及鉴别炎性病变和良性肿瘤是困难的。总体准确率为77%（骨，85%;软组织，68%）。结论：针吸活检是诊断肌肉骨骼系统病变的一种安全、准确的方法。
Background: Percutaneous needle biopsy has many advantages over open biopsy in the treatment of neoplasms. However, the accuracy of needle biopsy in the diagnosis of musculoskeletal lesions has not yet been established. Here, we evaluate the accuracy and limitations of the procedure for musculloskeletal lesions.Methods: The diagnoses of 163 needle biopsies (bone, 91; soft tissue, 72) performed on 157 consecutive patients using a Jamshidi needle or an Ostycut needle for bone lesions, or a Tru-cut needle for soft tissue lesions were compared with the final diagnoses made by open biopsy and/or a definitive operation.Results: One hundred forty-three specimens (88%) were determined to be adequate for histological examination. Obtaining undamaged cores from very hard bony lesions or sclerotic cyst walls proved difficult. A pathologist with experience in musculoskeletal lesions was able to differentiate malignant tumors from benign lesions in 97% of the cases (bone, 100%; soft tissue, 94%) and arrive at a specific diagnosis in 88% (bone, 96%; soft tissue, 78%) when adequate cores were obtained. Differentiating a well-differentiated liposarcoma from a benign lipoma and inflammatory lesions from benign tumorous conditions, was difficult. The overall accuracy was 77% (bone, 85%; soft tissue, 68%). There was no morbidity related to the procedure.Conclusion: The results indicate that needle biopsy is safe and accurate for diagnosing musculoskeletal lesions.