Avanzini Stefano, Faticato Maria Grazia, Crocoli Alessandro, Virgone Calogero, Viglio Camilla, Severi Elisa, Fagnani Anna Maria, Cecchetto Giovanni, Riccipetitoni Giovanna, Noccioli Bruno, Leva Ernesto, Sementa Angela Rita, Mattioli Girolamo, Inserra Alessandro
Department of Pediatric Surgery, IRCCS G. Gaslini, Genoa, Italy.
Department of Neuroscience, Rehabilitation, Ophtalmology, Gynecology, and Maternal-Infantile sciences (DINOGMI), University of Genoa, Genoa, Italy.
Pediatr Blood Cancer. 2017 May;64(5). doi: 10.1002/pbc.26284. Epub 2016 Oct 20.
Peripheral neuroblastic tumors are the most common extracranial solid neoplasms in children. Early and adequate tissue sampling may speed up the diagnostic process and ensure a prompt start of optimal treatment whenever needed. Different biopsy techniques have been described. The purpose of this multi-center study is to evaluate the accuracy and safety of the various examined techniques and to determine whether a preferential procedure exists.
All children who underwent a biopsy, from January 2010 to December 2014, as a result of being diagnosed with a peripheral neuroblastic tumor, were retrospectively reviewed. Data collected included patients' demographics, clinical presentation, intraoperative technical details, postoperative parameters, complications, and histology reports. The Mann-Whitney U and Fisher's exact tests were used for statistical analysis.
The cohort included 100 patients, 32 of whom underwent an incisional biopsy (performed through open or minimally invasive access) (Group A), and the remaining 68 underwent multiple needle-core biopsies (either imaging-guided or laparoscopy/thoracoscopy-assisted) (Group B). Comparing the two groups revealed that Group A patients had a higher rate of complications, a greater need for postoperative analgesia, and required red blood cell transfusion more often. Overall adequacy rate was 94%, without significant differences between the two groups (100% vs. 91.2% for Group A and Group B, respectively, P = 0.0933).
Both incision and needle-core biopsying methods provided sub-optimal to optimal sampling adequacy rates in children affected by peripheral neuroblastic tumors. However, the former method was associated with a higher risk of both intraoperative and postoperative complications compared with the latter.
外周神经母细胞瘤是儿童最常见的颅外实体瘤。早期且充分的组织采样可加快诊断进程，并在需要时确保及时开始最佳治疗。已有多种活检技术被描述。这项多中心研究的目的是评估各种检查技术的准确性和安全性，并确定是否存在优先采用的操作方法。
回顾性分析2010年1月至2014年12月期间因诊断为外周神经母细胞瘤而接受活检的所有儿童。收集的数据包括患者的人口统计学资料、临床表现、术中技术细节、术后参数、并发症及组织学报告。采用Mann-Whitney U检验和Fisher精确检验进行统计分析。
该队列包括100例患者，其中32例接受了切开活检（通过开放或微创途径进行）（A组），其余68例接受了多次针芯活检（影像引导或腹腔镜/胸腔镜辅助）（B组）。两组比较显示，A组患者并发症发生率更高，术后镇痛需求更大，更常需要输注红细胞。总体充分率为94%，两组间无显著差异（A组和B组分别为100%和91.2%，P = 0.0933）。
对于外周神经母细胞瘤患儿，切开活检和针芯活检方法提供的采样充分率均为次优至最优。然而，与后者相比，前一种方法术中及术后并发症风险更高。
