Department of Radiology, University of California, Davis Medical Center, Sacramento, California, USA.
J Ultrasound Med. 2020 Feb;39(2):239-245. doi: 10.1002/jum.15095. Epub 2019 Jul 22.
We undertook this retrospective review to compare the safety and diagnostic yield of core biopsy (CB) compared to fine-needle aspiration (FNA) in patients with suspected peritoneal malignancy.
This retrospective study included 35 patients who underwent ultrasound (US)-guided percutaneous biopsy of a peritoneal mass. Success rates of US-guided biopsy of these masses using the CB technique, FNA, or the combination of the two were compared. Outcomes of tissue adequacy, the final pathologic diagnosis, and complications were recorded. The binary outcome variable was adequate tissue obtained.
Adequate specimens were obtained in 94% (33 of 35) of the cases. There were 19 CBs, with 100% of samples sufficient for diagnosis (19 of 19). Thirty-one FNAs were performed, of which 7 were insufficient, with a diagnostic yield of 77% (24 of 31). There was a statistically significant difference between FNA and CB in providing more adequate tissue for diagnosis in our population (P = .035). There were no significant complications in either group.
The use of the CB technique when performing US-guided percutaneous biopsy of peritoneal masses provides better tissue for diagnosis compared to FNA. Additional benefits of CB, including genomic testing and tumor subtyping, make this technique a good addition to FNA, without significant complications.
我们进行这项回顾性研究，旨在比较在疑似腹膜恶性肿瘤患者中，核心活检（CB）与细针抽吸（FNA）的安全性和诊断效果。
本回顾性研究纳入了 35 名接受超声（US）引导下经皮腹膜肿块穿刺活检的患者。比较了使用 CB 技术、FNA 或两者联合进行 US 引导活检的成功率。记录了组织充分性、最终病理诊断和并发症等结果。二项分类结果变量为获得的组织是否充分。
在 35 例病例中，有 94%（33 例）获得了充分的标本。进行了 19 例 CB，其中 100%（19 例）的样本足以进行诊断。进行了 31 例 FNA，其中有 7 例样本不足，诊断率为 77%（24 例）。在为诊断提供更充分组织方面，FNA 和 CB 之间存在统计学显著差异（P =.035）。两组均无明显并发症。
在对腹膜肿块进行 US 引导经皮穿刺活检时，使用 CB 技术可提供比 FNA 更充分的诊断组织。与 FNA 相比，CB 技术的额外优势包括基因组检测和肿瘤分型，而且没有明显的并发症，是 FNA 的良好补充。
