Walker J Brock, Stockwell Erin, Worhacz Kellen, Kang Paul, Decomas Amalia
University of Arizona College of Medicine, Phoenix, AZ, USA.
The CORE Institute, Phoenix, AZ, USA.
Sarcoma. 2018 Jun 12;2018:1657864. doi: 10.1155/2018/1657864. eCollection 2018.
Percutaneous needle biopsy has been found to be a safe and accurate method for the initial investigation of soft tissue masses. The notion exists that needle biopsies should be performed in specialized sarcoma centers, which can place a financial burden on patients without a sarcoma center near their place of residence. There is no consensus in the current literature regarding the diagnostic accuracy and clinical utility of clinic-based percutaneous core needle biopsy performed by community orthopedic surgeons with fellowship training in musculoskeletal oncology.
QUESTIONS/PURPOSES: Our primary goal was to determine if office-based core needle biopsy of soft tissue masses could safely yield accurate diagnoses when performed by a community orthopedic surgeon with fellowship training in musculoskeletal oncology.
We retrospectively reviewed the charts of 105 patients who underwent percutaneous core needle biopsy of soft tissue masses in a community clinic. All procedures were performed by one fellowship-trained musculoskeletal oncologist. Accuracy of the initial clinic-based needle biopsy was determined through comparison to the results of pathological analysis of the surgically excised masses. Final data analysis included 69 patients who underwent both clinic-based biopsy and subsequent surgical excision of their masses.
We found clinic-based biopsies to be 87.0% accurate for exact diagnosis and 94.2% accurate in determining whether the mass was benign or malignant ( < 0.0001). Minor complications related to the clinic-based biopsy occurred in 5.80% of cases, with no documentation of major complications.
Our results provide evidence that office-based percutaneous biopsy can be administered safely and yield accurate, clinically useful results when performed by a fellowship-trained musculoskeletal oncologist.
经皮穿刺活检已被证明是对软组织肿块进行初步检查的一种安全且准确的方法。有一种观点认为，针吸活检应在专门的肉瘤中心进行，这可能会给居住地点附近没有肉瘤中心的患者带来经济负担。目前的文献中，对于接受肌肉骨骼肿瘤学 fellowship 培训的社区骨科医生进行的基于临床的经皮芯针活检的诊断准确性和临床实用性尚无共识。
问题/目的：我们的主要目标是确定，当由接受肌肉骨骼肿瘤学 fellowship 培训的社区骨科医生进行基于门诊的软组织肿块芯针活检时，是否能够安全地得出准确诊断。
我们回顾性分析了 105 例在社区诊所接受软组织肿块经皮芯针活检患者的病历。所有操作均由一名接受 fellowship 培训的肌肉骨骼肿瘤学家进行。通过与手术切除肿块的病理分析结果进行比较，确定基于临床的初始针吸活检的准确性。最终数据分析包括 69 例既接受了基于临床的活检又接受了后续肿块手术切除的患者。
我们发现基于临床的活检在准确诊断方面的准确率为 87.0%，在确定肿块是良性还是恶性方面的准确率为 94.2%（<0.0001）。与基于临床的活检相关的轻微并发症发生率为 5.80%，无重大并发症记录。
我们的结果表明，当由接受 fellowship 培训的肌肉骨骼肿瘤学家进行基于门诊的经皮活检时，可以安全实施并得出准确、具有临床实用价值的结果。
