Yang Yi Jun, Damron Timothy A
Department of Pathology, Upstate Medical University, State University of New York, Syracuse, NY, USA.
Arch Pathol Lab Med. 2004 Jul;128(7):759-64. doi: 10.5858/2004-128-759-CONCBA.
Needle core biopsy has been reported to be the choice of biopsy for musculoskeletal tumors. Fine-needle aspiration, on the other hand, has been widely accepted for nonmusculoskeletal tumors, but is only used in selected medical centers for musculoskeletal tumors. While fine-needle aspiration appears to have advantages to needle core biopsy in the aspects of simplicity and cost, the diagnostic accuracy should be the most critical parameter in determining the choice of biopsy. However, few studies comparing the diagnostic accuracy of these 2 biopsy methods have been performed.
This study was designed to compare the diagnostic accuracy of fine-needle aspiration and needle core biopsy in musculoskeletal tumors.
Prospective study was performed in patients aged 10 years or older. Diagnostic accuracy was compared in 50 consecutive concurrent needle core biopsies and fine-needle aspirations of musculoskeletal lesions.
For primary musculoskeletal lesions, fine-needle aspiration achieved a diagnostic accuracy rate of 88% for nature of lesion, 64% for specific diagnosis, 78% for histologic grading, and 74% for histologic typing. Needle core biopsy achieved an accuracy rate of 93% for nature of lesions, 83% for specific diagnosis, 83% for histologic grading, and 90% for histologic typing. Both biopsy methods have a higher diagnostic accuracy rate for high-grade tumors than for low-grade or benign lesions in determining the nature, specific diagnosis, and histologic grading.
The needle core biopsy has a higher diagnostic accuracy than fine-needle aspiration in all aspects, including determining the nature of the tumor, establishing the histologic type and grade, and achieving a specific diagnosis.
针芯活检已被报道为肌肉骨骼肿瘤活检的首选方法。另一方面，细针穿刺抽吸已被广泛应用于非肌肉骨骼肿瘤，但仅在部分医疗中心用于肌肉骨骼肿瘤。虽然细针穿刺抽吸在操作简便性和成本方面似乎比针芯活检具有优势，但诊断准确性应是决定活检方法选择的最关键参数。然而，很少有研究比较这两种活检方法的诊断准确性。
本研究旨在比较细针穿刺抽吸和针芯活检在肌肉骨骼肿瘤中的诊断准确性。
对10岁及以上患者进行前瞻性研究。对50例连续同时进行的肌肉骨骼病变针芯活检和细针穿刺抽吸的诊断准确性进行比较。
对于原发性肌肉骨骼病变，细针穿刺抽吸在病变性质诊断准确率为88%，特异性诊断为64%，组织学分级为78%，组织学类型为74%。针芯活检在病变性质诊断准确率为93%，特异性诊断为83%，组织学分级为83%，组织学类型为90%。在确定病变性质、特异性诊断和组织学分级方面，两种活检方法对高级别肿瘤的诊断准确率均高于低级别或良性病变。
针芯活检在确定肿瘤性质、建立组织学类型和分级以及进行特异性诊断等所有方面均比细针穿刺抽吸具有更高的诊断准确性。
