Ozerdemoglu Remzi A, Thompson Roby C, Transfeldt Ensor E, Cheng Edward Y
Department of Orthopaedic Surgery, Suleyman Demirel University, Isparta, Turkey.
Spine (Phila Pa 1976). 2003 May 1;28(9):909-15. doi: 10.1097/01.BRS.0000058722.83777.1A.
A retrospective study with statistical analysis of 25 percutaneous needle biopsies and 54 open biopsies performed on 60 patients with tumors located in the sacrococcygeal region.
To analyze the diagnostic value of open and needle biopsies in tumors of the sacrum as well as to determine factors leading to a false or equivocal result.
Although percutaneous needle biopsies of the spine are valuable for thoracolumbar levels, the benefit in the sacrococcygeal region, specifically, has not previously been shown. This region is unique because of anatomic and oncologic factors.
Medical charts, imaging studies, and operative and pathologic records of patients with tumors diagnosed between 1965 and 1996 in the sacrococcygeal region reviewed were analyzed. Accuracy and effective accuracy of each procedure were then calculated.
There were 54 primary lesions (17 benign, 37 malignant) and 6 metastatic tumors. The accuracy and effective accuracy of open biopsies was 87% and 81% but in percutaneous needle biopsies was only 44% and 12%, respectively. An unclear diagnosis resulted in the need for another biopsy in 12 of 21 primary percutaneous needle biopsies but only in 2 of 39 open biopsies (P < 0.0001, chi2). The average number of biopsies required to obtain a definitive diagnosis was significantly less if an open biopsy were performed first instead of a percutaneous needle biopsy, 1.1 versus 1.8, respectively (P = 0.0004, two-sample t test). There was a significant delay in treatment if the initial biopsy was a percutaneous needle biopsy compared with an open biopsy, mean 46 versus 4 days, respectively (P = 0.004, two-sample t test).
We conclude that for sacral tumors, open biopsies have a higher effective accuracy, whereas needle biopsies are associated with a longer delay in treatment.
一项回顾性研究，对60例骶尾区域肿瘤患者进行的25例经皮穿刺活检和54例切开活检进行统计分析。
分析切开活检和穿刺活检在骶骨肿瘤中的诊断价值，并确定导致假阳性或可疑结果的因素。
虽然经皮穿刺脊柱活检对胸腰段病变很有价值，但此前尚未证明其在骶尾区域的益处。由于解剖和肿瘤学因素，该区域具有独特性。
分析1965年至1996年间诊断为骶尾区域肿瘤患者的病历、影像学检查以及手术和病理记录。然后计算每种方法的准确性和有效准确性。
有54例原发性病变（17例良性，37例恶性）和6例转移性肿瘤。切开活检的准确性和有效准确性分别为87%和81%，而经皮穿刺活检仅为44%和12%。21例原发性经皮穿刺活检中有12例因诊断不明确需要再次活检，而39例切开活检中只有2例（P<0.0001，卡方检验）。如果首先进行切开活检而非经皮穿刺活检，获得明确诊断所需的平均活检次数显著减少，分别为1.1次和1.8次（P=0.0004，双样本t检验）。与切开活检相比，如果初始活检为经皮穿刺活检，治疗会有显著延迟，平均分别为46天和4天（P=0.004，双样本t检验）。
我们得出结论，对于骶骨肿瘤，切开活检具有更高的有效准确性，而穿刺活检会导致治疗延迟更长。
