Nikolaidis Paul, Silverman Stuart G, Cibas Edmund S, Vansonnenberg Eric, Rybicki Frank J, Manola Judith B, Tuncali Kemal, Karshbaum Steven H, Singer Samuel, Fletcher Christopher D M, Demetri George D
Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Eur Radiol. 2005 Feb;15(2):383-9. doi: 10.1007/s00330-004-2501-3. Epub 2004 Oct 6.
The purpose of the study was to evaluate the feasibility of image-guided percutaneous needle biopsy to enable specific subtype classification of liposarcoma in patients with previously diagnosed disease and compare the yield of fine and large needle techniques for each subtype. We reviewed the medical records and pathology reports of 69 fine (20 g) needle and large (15, 16 g) needle biopsies performed in 44 patients enrolled in a clinical trial evaluating the effect of a novel therapy for advanced liposarcoma in the abdomen and pelvis. Cytopathologists and surgical pathologists identified features that enabled them to classify the tumor into one of four subtypes: well differentiated, myxoid/round cell, pleomorphic and dedifferentiated. The pre-study open surgical biopsy was used as the standard for comparison. The diagnostic yield (proportion of biopsies with correct subtype diagnosis) of percutaneous biopsy for identifying all subtypes of liposarcoma was 81% (64% for fine needles and 73% for large needles alone). There was a significant association between pathologic subtype and the probability of a correct diagnosis (P=0.05). Accurate diagnostic subset classification of liposarcoma by percutaneous biopsy is feasible, although both fine and large needles should be used. Although these data cannot be extrapolated to primary diagnosis of liposarcoma, they are important for screening and subtyping of possible recurrence.
本研究的目的是评估影像引导下经皮穿刺活检在已确诊脂肪肉瘤患者中实现特定亚型分类的可行性，并比较细针和粗针技术对各亚型的取材成功率。我们回顾了44例参加评估腹部和盆腔晚期脂肪肉瘤新型治疗效果临床试验患者的69次细针（20G）和粗针（15G、16G）活检的病历和病理报告。细胞病理学家和外科病理学家识别出能够将肿瘤分为四种亚型之一的特征：高分化型、黏液样/圆形细胞型、多形性和去分化型。研究前的开放性手术活检用作比较标准。经皮活检对所有脂肪肉瘤亚型进行诊断的取材成功率（正确亚型诊断的活检比例）为81%（细针单独取材成功率为64%，粗针单独取材成功率为73%）。病理亚型与正确诊断概率之间存在显著相关性（P=0.05）。经皮活检对脂肪肉瘤进行准确的诊断亚组分类是可行的，尽管细针和粗针都应使用。虽然这些数据不能外推至脂肪肉瘤的初诊，但它们对可能复发的筛查和亚型分类很重要。
