Oldrini Guillaume, Leroux Agnès, Vogin Guillaume, Rios Maria, Marchal Frédéric, Sirveaux François, Verhaeghe Jean-Luc, Renard-Oldrini Sophie, Lesanne Grégory, Salleron Julia, Henrot Philippe
Institut de cancérologie de Lorraine, service d'imagerie, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
Institut de cancérologie de Lorraine, service d'anatomopathologie, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
Presse Med. 2016 Nov;45(11):e363-e368. doi: 10.1016/j.lpm.2016.01.036. Epub 2016 Sep 3.
Suspicious lesions of sarcoma require preoperative biopsies. If surgical biopsies remain the gold standard, radioguided percutaneous microbiopsies are gaining an increasing importance. The purpose of this study was to compare histopathological results of percutaneous biopsies of soft tissues, trunk and retroperitoneal tumors with the histopathological results of operative specimens.
This is a retrospective study including 84 patients treated in our institution. The concordance between the results of the microbiopsy and the operative specimen for the benign-malignant differentiation and the histological type was evaluated. The microbiopsy accuracy was calculated. The sensitivity and the specificity of the microbiopsies compared to the operative specimen were also evaluated for the benign-malignant differentiation.
The concordance was 0.92 [0.79-1] for the benign-malignant differentiation, 0.97 [0.92-1] for the histological type. The accuracy of microbiopsies was therefore 96% (sensibility=97.0%; specificity=94.1%) for the benign-malignant detection and 97.8% for the histological type.
Percutaneous microbiopsies play an important part in the diagnosis of soft tissue tumors of the limbs, trunk and retroperitoneum, in particular as a replacement to more invasive surgical biopsies. This study evidences the increasing importance of the collaboration between radiologist, surgeon and pathologist in the diagnosis of sarcoma.
肉瘤的可疑病变需要进行术前活检。如果手术活检仍是金标准，那么放射性引导下经皮细针穿刺活检正变得越来越重要。本研究的目的是比较软组织、躯干和腹膜后肿瘤经皮活检的组织病理学结果与手术标本的组织病理学结果。
这是一项回顾性研究，纳入了在我们机构接受治疗的84例患者。评估了细针穿刺活检结果与手术标本在良恶性鉴别及组织学类型方面的一致性。计算了细针穿刺活检的准确性。还比较了细针穿刺活检与手术标本在良恶性鉴别方面的敏感性和特异性。
在良恶性鉴别方面，一致性为0.92[0.79 - 1]，在组织学类型方面为0.97[0.92 - 1]。因此，细针穿刺活检在良恶性检测方面的准确性为96%（敏感性 = 97.0%；特异性 = 94.1%），在组织学类型方面为97.8%。
经皮细针穿刺活检在四肢、躯干和腹膜后软组织肿瘤的诊断中起着重要作用，特别是作为更具侵入性的手术活检替代方法。本研究证明了放射科医生、外科医生和病理科医生在肉瘤诊断中合作的重要性日益增加。
