Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA.
Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA.
J Neurooncol. 2021 Aug;154(1):1-11. doi: 10.1007/s11060-021-03785-9. Epub 2021 Jul 12.
Stereotactic needle biopsy remains the cornerstone for tissue diagnosis for tumors located in regions of the brain that are difficult to access through open surgery.
We perform a meta-analysis of the literature to examine the relation between number of samples taken during biopsy and diagnostic yield, morbidity and mortality.
We identified 2416 patients from 28 cohorts in studies published in PubMed database that studied stereotactic needle biopsies for tumor indications. Meta-analysis by proportions and meta-regression analyses were performed.
On meta-analysis, the morbidity profile of the published needle biopsy studies clustered into three groups: studies that performed < 3 samples (n = 8), 3-6 samples (n = 13), and > 6 samples during biopsy (n = 7). Pooled estimates for biopsy related morbidity were 4.3%, 16.3%, and 17% for studies reporting < 3, 3-6, and > 6 biopsy samples, respectively. While these morbidity estimates significantly differed (p < 0.001), the diagnostic yields reported for studies performing < 3 biopsies, 3-6 samples, and > 6 samples were comparable. Pooled estimates of diagnostic yield for these three groups were 90.4%, 93.8%, and 88.1%, respectively. Mortality did not significantly differ between studies reporting differing number of samples taken during biopsy.
Our meta-analysis suggests that morbidity risk in needle biopsy is non-linearly associated with the number of samples taken. There was no association between the number of biopsies taken, and diagnostic yield or mortality.
立体定向针活检仍然是难以通过开颅手术到达的脑区肿瘤组织诊断的基石。
我们对文献进行荟萃分析，以检查活检过程中采集的样本数量与诊断率、发病率和死亡率之间的关系。
我们从 Pubmed 数据库中发表的研究中确定了 2416 名患者，这些研究是针对肿瘤指征进行立体定向针活检的。采用比例荟萃分析和荟萃回归分析。
荟萃分析中，发表的针活检研究的发病率特征分为三组：进行<3 次活检（n=8）、3-6 次活检（n=13）和>6 次活检（n=7）。报告<3、3-6 和>6 次活检样本的研究中，活检相关发病率的汇总估计值分别为 4.3%、16.3%和 17%。尽管这些发病率估计值差异显著（p<0.001），但进行<3 次活检、3-6 次样本和>6 次样本的研究报告的诊断率相似。这三组的诊断率汇总估计值分别为 90.4%、93.8%和 88.1%。报告活检样本数量不同的研究之间，死亡率无显著差异。
我们的荟萃分析表明，针活检的发病率风险与采集的样本数量呈非线性相关。活检采集的样本数量与诊断率或死亡率之间没有关联。
