Oliveira Marcelo Parente, Lima Pablo Moura de Andrade, de Mello Roberto José Vieira
Orthopedist in the Orthopedics and Traumatology Clinic, HC-UFPE; Auxiliary Professor in the Cariri School of Medicine, Federal University of Ceará; Master's student in the Postgraduate Pathology Program, CCS-UFPE, Recife, PE, Brazil.
MSc in Pathology from the Federal University of Pernambuco; Orthopedist responsible for the Orthopedic Oncology Group, Orthopedics and Traumatology Clinic, HC-UFPE, Recife, PE, Brazil.
Rev Bras Ortop. 2015 Nov 4;47(5):631-7. doi: 10.1016/S2255-4971(15)30015-X. eCollection 2012 Sep-Oct.
To study factors possibly associated with tumor contamination in the biopsy path of primary malignant bone tumors.
Thirty-five patients who underwent surgical treatment with diagnoses of osteosarcoma, Ewing's tumor and chondrosarcoma were studied retrospectively. The sample was analyzed to characterize the biopsy technique used, histological type of the tumor, neoadjuvant chemotherapy used, local recurrences and tumor contamination in the biopsy path.
Among the 35 patients studied, four cases of contamination occurred (11.43%): one from osteosarcoma, two from Ewing's tumor and one from chondrosarcoma. There was no association between the type of tumor and presence of tumor contamination in the biopsy path (p = 0.65). There was also no association between the presence of tumor contamination and the biopsy technique (p = 0.06). On the other hand, there were associations between the presence of tumor contamination and local recurrence (p = 0.01) and between tumor contamination and absence of neoadjuvant chemotherapy (p = 0.02).
Tumor contamination in the biopsy path of primary malignant bone tumors was associated with local recurrence. On the other hand, the histological type of the tumor and the type of biopsy did not have an influence on tumor contamination. Neoadjuvant chemotherapy had a protective effect against this complication. Despite these findings, tumor contamination is a complication that should always be taken into consideration, and removal of the biopsy path is recommended in tumor resection surgery.
研究可能与原发性恶性骨肿瘤活检路径中肿瘤污染相关的因素。
回顾性研究35例诊断为骨肉瘤、尤因肉瘤和软骨肉瘤并接受手术治疗的患者。对样本进行分析,以确定所使用的活检技术、肿瘤的组织学类型、新辅助化疗的使用情况、局部复发情况以及活检路径中的肿瘤污染情况。
在研究的35例患者中,发生了4例污染(11.43%):1例来自骨肉瘤,2例来自尤因肉瘤,1例来自软骨肉瘤。肿瘤类型与活检路径中肿瘤污染的存在之间无关联(p = 0.65)。肿瘤污染的存在与活检技术之间也无关联(p = 0.06)。另一方面,肿瘤污染的存在与局部复发之间存在关联(p = 0.01),且肿瘤污染与未进行新辅助化疗之间存在关联(p = 0.02)。
原发性恶性骨肿瘤活检路径中的肿瘤污染与局部复发相关。另一方面,肿瘤的组织学类型和活检类型对肿瘤污染没有影响。新辅助化疗对这种并发症有保护作用。尽管有这些发现,但肿瘤污染是一种应始终予以考虑的并发症,建议在肿瘤切除手术中切除活检路径。