School of Medicine, Division of Rheumatology, University of New Mexico Health Sciences Center, Albuquerque, USA.
Amyloid. 2012 Jun;19(2):66-73. doi: 10.3109/13506129.2012.666508. Epub 2012 Mar 27.
Subcutaneous fat biopsy is useful for the evaluation of amyloidosis, environmental contaminants, lipid metabolism, genetic studies and diabetes research. The present study examined new technologies for fat biopsy.
Subcutaneous fat biopsy in 10 high-risk individuals was randomized to (i) a 10 ml reciprocating procedure device (RPD) mechanical syringe or (ii) a 60 ml vacuum syringe. Outcome measures included pain by the 10 cm Visual Analogue Pain Scale (VAS), adequacy of biopsied tissue, complications and diagnosis. The operator's ability to control syringes was quantitatively measured by the linear displacement method.
Both syringes permitted facile aspiration of subcutaneous fat with adequate sample without complications. The mechanical and the vacuum syringes enhanced control of the needle compared to conventional syringes, reducing unintended forward penetration by 75% (3.6 ± 0.5 mm) and 87% (12.0 ± 1.4 mm), respectively (p < 0.0001). Free adipose cells were obtained in abundance as well as columnar biopsies containing intact blood vessels and connective tissue septa permitting precise microhistological examination. One case of primary AL amyloidosis (κ light chain disease) was diagnosed in each group.
Subcutaneous fat biopsy by needle aspiration can be facilely achieved with new aspiration syringe technologies with improved needle control and enhanced patient safety.
皮下脂肪活检对于淀粉样变性、环境污染物、脂质代谢、遗传研究和糖尿病研究的评估很有用。本研究检查了脂肪活检的新技术。
对 10 名高危个体进行皮下脂肪活检,随机分为(i)10ml 往复式手术设备(RPD)机械注射器或(ii)60ml 真空注射器。观察指标包括 10cm 视觉模拟疼痛量表(VAS)的疼痛程度、活检组织的充分性、并发症和诊断。操作人员通过线性位移法定量测量对注射器的控制能力。
两种注射器都能轻松抽吸皮下脂肪,获得足够的样本,没有并发症。与传统注射器相比,机械注射器和真空注射器增强了对针头的控制,分别减少了 75%(3.6±0.5mm)和 87%(12.0±1.4mm)的意外前向穿透(p<0.0001)。都能获得丰富的游离脂肪细胞和柱状活检标本,其中包含完整的血管和结缔组织隔,允许进行精确的组织学检查。每组均诊断出一例原发性 AL 淀粉样变性(κ轻链病)。
使用新的抽吸注射器技术可以轻松地进行皮下脂肪活检,这些技术增强了对针头的控制,提高了患者的安全性。