Reliability of prognostic factors in breast carcinoma determined by core needle biopsy
Reliability of prognostic factors in breast carcinoma determined by core needle biopsy
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DOI：
10.1093/jjco/hym021
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发表时间：
2007-04-01
影响因子：
2.4
通讯作者：
Ohuchi, Noriaki
中科院分区：
文献类型：
--
作者：
Usami, Shin;Moriya, Takuya;Ohuchi, Noriaki
目的：本研究的目的是评估空芯针穿刺活检（CNB）获得的信息的可靠性。方法：我们研究了111名妇女（112个病灶）乳腺癌进行CNB和随后的手术切除。6个因素（组织学类型，核分级，组织学分级，雌激素受体（ER）的状态，孕激素受体（PR）的状态，和人表皮生长因子受体-2（HER 2）的状态）进行了评估，在一个盲法在CNB和手术切除。在CNB的45个原位病变中，16个（36%）在手术切除时发现有浸润性癌。CNB标本与手术标本的绝对符合率和Kappa统计值的差异为61%，Kappa值为中等在核分级中，75%的细胞具有中等Kappa值，组织学分级为0.55，95%，Kappa值接近完美在ER中，88%具有显著的kappa值（0.84），在PR中，88%具有显著的kappa值（0.70），在HER 2中，88%具有显著的kappa值（0.65）。关于核和组织学分级的评价，更大的准确性的趋势，观察时，较厚的标本used.Conclusions：CNB提供了可靠的信息，浸润性癌的组织学类型。尽管使用细针（16号）获得的标本数量有限，但它还准确评价了ER、PR和HER 2（仅在评分为3+的病例中）。
Objective: The aim of this study was to evaluate the reliability of information obtained by core needle biopsy (CNB).Methods: We studied 111 women (112 lesions) with breast cancer who underwent CNB and subsequent surgical excision. Six factors (histological type, nuclear grade, histological grade, estrogen receptor (ER) status, progesterone receptor (PR) status, and human epidermal growth factor receptor-2 (HER2) status) were evaluated in a blinded fashion at CNB and at surgical excision.Results: The histological type at CNB correlated exactly with that of the excisional specimen in 83% (87/105) of the cases. Of the 45 in situ lesions at CNB, 16 (36%) were found to have invasive carcinoma at surgical excision. The difference between the specimens from CNB and those from surgery in terms of the absolute concordance rate and kappa statistic value were 61% with a fair kappa value (0.26) in the nuclear grade, 75% with a moderate kappa value (0.55) in the histological grade, 95% with an almost perfect kappa value (0.84) in ER, 88% with a substantial kappa value (0.70) in PR and 88% with a substantial kappa value (0.65) in HER2. Regarding the evaluation of nuclear and histological grades, a trend toward greater accuracy was observed when thicker specimens were used.Conclusions: CNB provided reliable information on the histological type of invasive carcinoma. It also evaluated ER, PR and HER2 (only in cases where the score was 3+) accurately in spite of the limited quantity of the specimen obtained with the thin (16-gauge) needle.