Mutlu Yaşa Gül, Balık Aydın Berrin, Çakır Aslı, Canöz Özlem, Erol Cengiz, Gökmen Sevindik Ömür
Department of Hematology, Istanbul Medipol University, Istanbul, Turkey.
Department of Pathology, Istanbul Medipol University, Istanbul, Turkey.
Eurasian J Med. 2023 Jun;55(2):114-119. doi: 10.5152/eurasianjmed.2023.0060.
Surgical excisional biopsy is accepted as the standard of care approach in the diagnosis of lympho- mas. Financial issues related to the increased cost and the invasive nature of the procedure forced physicians to use some alternative diagnostic methods. Percutaneous core needle biopsy, which gained a reputation for the diagnosis of lymphomas with the advent of improved pathological, immunohistochemical, and molecular analysis, made it possible to have an accurate diagnosis with limited tissue samples. In this retrospective study, we aimed to compare the diagnostic yield of surgical excisional biopsy and core needle biopsy.
This study included 131 patients who were diagnosed with lymphoma with a nodal biopsy which was acquired via surgical excisional biopsy or core needle biopsy between 2014 and 2020 in our center. Around 68 patients underwent surgical excisional biopsy and the remaining 63 underwent core needle biopsy. Samples that allowed to the identification of the exact tumor type and/or subtype were accepted as fully diagnostic. Sufficient amount of tissue that the pathologist could have any suspicious findings considering malignant lymphoma was classified as partial diagnostic group. Inadequate samples were the ones who were not enough to report any final diagnosis.
The patients who underwent a core needle biopsy were significantly older than the patients who underwent to surgical excisional biopsy (56.8 vs. 47.6, P = .003). Despite the full diagnostic ability of surgical excisional biopsy outperformed core needle biopsy (95.2 % vs. 83.8 %, P=.035), in 92.6% of the patients whose tissue samples were obtained via core needle biopsy were accepted to have a sufficient diagnosis to initiate the treatment and not required a second biopsy, which was comparable with the ones achieved by surgical excisional biopsy (92.6% vs. 95.2%, P = .720).
According to the results obtained in our study, we may conclude that core needle biopsy is a viable and comparable alternative to surgical excisional biopsy, offering a less invasive and less-expansive approach.
手术切除活检被公认为淋巴瘤诊断的标准治疗方法。与该手术成本增加及侵入性相关的经济问题迫使医生采用一些替代诊断方法。随着病理、免疫组织化学和分子分析技术的改进，经皮穿刺活检在淋巴瘤诊断方面赢得了声誉，使得利用有限的组织样本进行准确诊断成为可能。在这项回顾性研究中，我们旨在比较手术切除活检和穿刺活检的诊断率。
本研究纳入了2014年至2020年期间在我们中心通过手术切除活检或穿刺活检进行淋巴结活检而被诊断为淋巴瘤的131例患者。约68例患者接受了手术切除活检，其余63例接受了穿刺活检。能够确定确切肿瘤类型和/或亚型的样本被视为完全诊断性样本。病理学家考虑恶性淋巴瘤可能有任何可疑发现的足够组织量样本被归类为部分诊断组。样本不足是指不足以报告任何最终诊断的样本。
接受穿刺活检的患者明显比接受手术切除活检的患者年龄大（56.8岁对47.6岁，P = 0.003）。尽管手术切除活检的完全诊断能力优于穿刺活检（95.2%对83.8%，P = 0.035），但在通过穿刺活检获得组织样本的患者中，92.6%的患者被认为有足够的诊断结果来开始治疗，无需再次活检，这与手术切除活检的结果相当（92.6%对95.2%，P = 0.720）。
根据我们研究获得的结果，我们可以得出结论，穿刺活检是手术切除活检可行且相当的替代方法，提供了一种侵入性较小且费用较低的途径。
