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脑肿瘤的内镜活检：技术重要吗？

Endoscopic biopsy of brain tumors: Does the technique matter?

作者信息

Azab Waleed A, Nasim Khurram, Chelghoum Abdelaziz, Parwez Aslam, Salaheddin Waleed

机构信息

Neurosurgery Department, Ibn Sina Hospital, Kuwait City, Kuwait.

出版信息

Surg Neurol Int. 2014 Nov 12;5:159. doi: 10.4103/2152-7806.144597. eCollection 2014.

DOI:10.4103/2152-7806.144597
PMID:25506504
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4253053/
Abstract

BACKGROUND

Endoscopic biopsy of brain tumors is an important part of the armamentarium of management of intra- and periventricular tumors that is generally considered an acceptable and, in some situations, a preferred method for tissue sampling. The diagnostic yield of the procedure has been variably reported. Technical aspects of the procedure should undoubtedly reflect on its success rate and accuracy. Such impact on diagnostic yield of endoscopic brain biopsy is infrequently discussed in the literature.

METHODS

A search of the medical literature was conducted for publications on endoscopic brain biopsy. These reports were analyzed regarding the various technical aspects.

RESULTS

In the 43 publications analyzed, lenscopes were exclusively used in 22 reports and a tissue diagnosis was possible in 362 out of 387 endoscopic biopsies with a diagnostic yield of 93.54%. Only fiberscopes were used in 8 reports and a tissue diagnosis was possible in 100 out of 132 endoscopic biopsies with a diagnostic yield of 75.76%. The diagnostic yield in the mixed and unspecified groups was 88.95 and 88.04%, respectively. Very few details on the histopathological methods and tumor molecular genetics could be found.

CONCLUSION

Endoscopic biopsy of brain tumors has a higher diagnostic yield when lenscopes are used. Neuronavigation seems to add to the diagnostic accuracy of the procedure. Studies detailing molecular genetic features of biopsied tumors are necessary in the future.

摘要

背景

脑肿瘤的内镜活检是脑室内和脑室周围肿瘤治疗手段的重要组成部分，通常被认为是一种可接受的组织取样方法，在某些情况下还是首选方法。该操作的诊断率报道不一。该操作的技术方面无疑会影响其成功率和准确性。然而，内镜脑活检技术对诊断率的这种影响在文献中很少被讨论。

方法

检索医学文献中关于内镜脑活检的出版物，并对这些报告的各个技术方面进行分析。

结果

在分析的43篇出版物中，22篇报告仅使用了硬镜，387例内镜活检中有362例获得了组织诊断，诊断率为93.54%。8篇报告仅使用了纤维镜，132例内镜活检中有100例获得了组织诊断，诊断率为75.76%。混合组和未明确组的诊断率分别为88.95%和88.04%。关于组织病理学方法和肿瘤分子遗传学的细节很少。

结论

使用硬镜进行脑肿瘤内镜活检的诊断率更高。神经导航似乎提高了该操作的诊断准确性。未来有必要开展详细研究活检肿瘤分子遗传特征的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d6/4253053/1b042181f50f/SNI-5-159-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d6/4253053/d11a6148a185/SNI-5-159-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d6/4253053/4b8408b459d2/SNI-5-159-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d6/4253053/9ae4c471a632/SNI-5-159-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d6/4253053/1b042181f50f/SNI-5-159-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d6/4253053/d11a6148a185/SNI-5-159-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d6/4253053/4b8408b459d2/SNI-5-159-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d6/4253053/9ae4c471a632/SNI-5-159-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d6/4253053/1b042181f50f/SNI-5-159-g007.jpg

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Surgical navigation-assisted endoscopic biopsy is feasible for safe and reliable diagnosis of unresectable solid brain tumors.手术导航辅助内镜活检对于无法切除的实体脑肿瘤的安全可靠诊断是可行的。
Neurosurg Rev. 2013 Oct;36(4):595-600; discussion 600-1. doi: 10.1007/s10143-013-0467-9. Epub 2013 Apr 9.
3
Transventricular endoscopic biopsy of suprasellar tumors: a pediatric case series.
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4
Intraparenchymal brain lesion biopsy guided by a rigid endoscope and navigation system.在硬式内窥镜和导航系统引导下进行脑实质内病变活检。
Surg Neurol Int. 2015 Sep 18;6:149. doi: 10.4103/2152-7806.165764. eCollection 2015.
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