Dept. of Women's and Children's Health, Section of Pediatrics, University Children's Hospital, Uppsala.
Dept. of Women's and Children's Health, Section of Pediatric Surgery, University Children's Hospital, Uppsala.
J Pediatr Surg. 2019 Jun;54(6):1253-1256. doi: 10.1016/j.jpedsurg.2018.12.023. Epub 2019 Jan 4.
Neuroblastoma (NB) is the most common extracranial solid tumor of childhood and accounts for 15% of deaths in pediatric oncology. Apart from the clinical stage at diagnosis, molecular factors are important for the characterization of the tumor and for decision on adequate treatment. Pretreatment diagnosis and molecular profiling are based on analysis of a tumor sample, obtained either by fine needle aspiration cytology (FNAC), cutting needle biopsy or open surgical biopsy. The method used depends on local tradition and routines. Ultrasound-guided cutting needle biopsy (UCNB) has been used at the Uppsala University Hospital since 1988 for diagnosis of pediatric solid tumors.
Medical records of 29 patients with NB who underwent pretreatment, diagnostic, ultrasound-guided needle biopsy were reviewed. Information extracted from the patients' records included: age at diagnosis, gender, tumor site, clinical stage, molecular profiling made on biopsies (e.g. MYCN status, ploidy and chromosomal aberrations), and UCNB complications (i.e. bleeding, pain, or anesthesiologic complications).
A total of 34 UCNBs were performed in the 29 patients. Repeated biopsies were done in three patients. UCNB was diagnostic in 90% (26/29). A complete molecular profiling was obtained in all UCNBs after 2008. Two patients (7%) developed a significant bleeding and two (7%) needed analgesics following UCNB. Neither infection nor tumor growth in the needle tract was observed. There were no anesthesiologic complications.
UCNB is reasonably safe in patients with NB and usually gives a sufficient amount of tumor tissue for a histological diagnosis, molecular profiling, and biobank storage.
神经母细胞瘤（NB）是儿童期最常见的颅外实体瘤，占儿科肿瘤死亡人数的 15%。除了诊断时的临床分期外，分子因素对于肿瘤的特征描述和确定适当的治疗方案非常重要。治疗前的诊断和分子分析基于对肿瘤样本的分析，这些样本可以通过细针穿刺细胞学（FNAC）、切割针活检或开放性手术活检获得。所使用的方法取决于当地的传统和惯例。自 1988 年以来，乌普萨拉大学医院一直使用超声引导的切割针活检（UCNB）来诊断儿科实体瘤。
对 29 例接受治疗前、诊断性、超声引导下穿刺活检的 NB 患者的病历进行了回顾。从患者记录中提取的信息包括：诊断时的年龄、性别、肿瘤部位、临床分期、活检的分子分析结果（例如 MYCN 状态、倍性和染色体异常）以及 UCNB 并发症（即出血、疼痛或麻醉并发症）。
在 29 例患者中进行了 34 次 UCNB。3 例患者进行了重复活检。90%（26/29）的 UCNB 具有诊断意义。2008 年后，所有 UCNB 均获得了完整的分子分析结果。2 例患者（7%）在 UCNB 后出现明显出血，2 例患者（7%）需要使用镇痛药。未观察到感染或肿瘤在针道内生长。无麻醉并发症。
UCNB 在 NB 患者中相对安全，通常可获得足够量的肿瘤组织进行组织学诊断、分子分析和生物库储存。
