Winkler D, Fritzsche H, Schaser K-D, Hofbauer C
Universitätsklinikum Carl Gustav Carus, UniversitätsCentrum für Orthopädie & Unfallchirurgie, Technische Universität Dresden, Anstalt des öffentlichen Rechts des Freistaates Sachsen, Fetscherstraße 74, 01307, Dresden, Deutschland.
Orthopade. 2020 Feb;49(2):88-97. doi: 10.1007/s00132-020-03875-y.
Biopsy followed by histopathological assessment is the key procedure to establish the correct diagnosis of unclear bone or soft tissue tumors. There are several possibilities to obtain a biopsy specimen. The indication for biopsy should be established in a specialized center, as should the type of biopsy (fine needle, incisional, excisional, percutaneous CT-guided/navigated biopsy), which must be performed according to established guidelines. The tumor biopsy must be representative and adequate in terms of quantity, to enable a conclusive histopathological diagnosis and planning of appropriate treatment. For the correct biopsy tract, the surgical approach for definitive resection must be considered; thus, biopsy should be conducted in the center where the subsequent resection will be performed. Of note, patients whose biopsy is performed at a specialized musculoskeletal tumor center benefit in terms of improved local tumor control.
活检后进行组织病理学评估是明确诊断不明的骨或软组织肿瘤的关键步骤。获取活检标本有多种方法。活检的指征应在专业中心确定,活检类型(细针穿刺活检、切开活检、切除活检、经皮CT引导/导航活检)也应如此,必须按照既定指南进行。肿瘤活检在数量上必须具有代表性且足够,以便做出确定性的组织病理学诊断并规划适当的治疗方案。为了获得正确的活检路径,必须考虑最终切除的手术入路;因此,活检应在后续进行切除手术的中心进行。值得注意的是,在专业肌肉骨骼肿瘤中心进行活检的患者在改善局部肿瘤控制方面受益。