Department of Diagnostic and Interventional Radiology, Aichi Cancer Center, Japan.
Department of Diagnostic and Interventional Radiology, Aichi Cancer Center, Japan.
Eur J Radiol. 2020 Jun;127:108990. doi: 10.1016/j.ejrad.2020.108990. Epub 2020 Apr 13.
This study aimed to compare the efficacy and safety of image-guided core needle biopsy (CNB) with those of surgical excision biopsy (SEB) for the diagnosis of lymphoma, and to clarify the indication of CNB in clinical practice.
This retrospective study included 263 image-guided CNB cases and 108 SEB cases that were performed at our institution between January 2014 and December 2018. The rate of patients with performance status of grade 1-4 was higher in the CNB group than in the SEB group (43.7% vs. 24.1%, P < 0.01). Waiting time to biopsy and diagnosis was shorter for CNB group than for SEB group (4 days vs. 7 days, 13 days vs. 15 days, P < 0.01). The rate of biopsy at the deep sites was higher in the CNB group than in the SEB group (53.2% vs. 8.3%, P < 0.01). Successful biopsy and complication rates were compared between the 2 groups.
There were no significant differences between the CNB and SEB groups in successful biopsy rates (89.0% vs. 93.5%, P = 0.25). The grade 3 complication rate was significantly lower for CNB group than for SEB group (0% vs. 4.6%, P < 0.01), although there was no significant difference in overall complication rates (4.9% vs. 6.5%, respectively, P = 0.61).
CNB showed high diagnostic yield comparable to SEB for suspected lymphoma. CNB was especially recommended to the cases with low-PS, lesions in the deep sites, and requiring early pathological diagnosis.
本研究旨在比较影像学引导下的核心针活检（CNB）与手术切除活检（SEB）在淋巴瘤诊断中的疗效和安全性，并阐明 CNB 在临床实践中的适应证。
本回顾性研究纳入了 2014 年 1 月至 2018 年 12 月期间在我院行 CNB 检查的 263 例患者和 SEB 检查的 108 例患者。CNB 组患者的体力状况评分（PS）为 1-4 级的比例高于 SEB 组（43.7% vs. 24.1%，P<0.01）。CNB 组的活检等待时间和诊断等待时间均短于 SEB 组（4 天 vs. 7 天，13 天 vs. 15 天，P<0.01）。CNB 组活检的深部部位比例高于 SEB 组（53.2% vs. 8.3%，P<0.01）。比较了两组患者的活检成功率和并发症发生率。
CNB 组和 SEB 组的活检成功率（89.0% vs. 93.5%，P=0.25）无显著差异。CNB 组的 3 级并发症发生率显著低于 SEB 组（0% vs. 4.6%，P<0.01），但总并发症发生率无显著差异（4.9% vs. 6.5%，P=0.61）。
CNB 对疑似淋巴瘤的诊断具有与 SEB 相当的高诊断率。对于 PS 较低、深部病变和需要早期病理诊断的患者，推荐使用 CNB。
