Mahr A, Saba M, Kambouchner M, Polivka M, Baudrimont M, Brochériou I, Coste J, Guillevin L
Department of Internal Medicine, Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France.
Ann Rheum Dis. 2006 Jun;65(6):826-8. doi: 10.1136/ard.2005.042770.
To investigate the relation between temporal artery biopsy (TAB) length and diagnostic sensitivity for giant cell arteritis.
Histological TAB reports generated from four hospital pathology departments were reviewed for demographics, histological findings, and formalin fixed TAB lengths. A biopsy was considered positive for giant cell arteritis if there was a mononuclear cell infiltrate predominating at the media-intima junction or in the media.
Among 1821 TAB reports reviewed, 287 (15.8%) were excluded because of missing data, sampling errors, or age < 50 years. Mean TAB length of the 1520 datasets finally analysed (67.2% women; mean (SD) age, 73.1 (10.0) years) was 1.33 (0.73) cm. Histological evidence of giant cell arteritis was found in 223 specimens (14.7%), among which 164 (73.5%) contained giant cells. Statistical analyses, including piecewise logistic regression, identified 0.5 cm as the TAB length change point for diagnostic sensitivity. Compared with TAB length of < 0.5 cm, the respective odds ratios for positive TAB without and with multinucleated giant cells in samples > or = 0.5 cm long were 5.7 (95% confidence interval, 1.4 to 23.6) and 4.0 (0.97 to 16.5).
A fixed TAB length of at least 0.5 cm could be sufficient to make a histological diagnosis of giant cell arteritis.
探讨颞动脉活检（TAB）长度与巨细胞动脉炎诊断敏感性之间的关系。
回顾了四个医院病理科生成的组织学TAB报告，以获取人口统计学信息、组织学发现和福尔马林固定的TAB长度。如果在中膜-内膜交界处或中膜有以单核细胞浸润为主，则活检被认为巨细胞动脉炎呈阳性。
在审查的1821份TAB报告中，287份（15.8%）因数据缺失、抽样误差或年龄<50岁而被排除。最终分析的1520个数据集（67.2%为女性；平均（标准差）年龄为73.1（10.0）岁）的平均TAB长度为1.33（0.73）cm。在223个标本（14.7%）中发现了巨细胞动脉炎的组织学证据，其中164个（73.5%）含有巨细胞。包括分段逻辑回归在内的统计分析确定0.5 cm为诊断敏感性的TAB长度变化点。与<0.5 cm的TAB长度相比，长度≥0.5 cm的样本中无多核巨细胞和有多核巨细胞的TAB阳性的相应优势比分别为5.7（95%置信区间，1.4至23.6）和4.0（0.97至16.5）。
至少0.5 cm的固定TAB长度可能足以进行巨细胞动脉炎的组织学诊断。
