Departments of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Imaging Department, Institut Curie, Paris, France.
Pediatr Blood Cancer. 2024 Feb;71(2):e30789. doi: 10.1002/pbc.30789. Epub 2023 Nov 27.
Image-guided core-needle biopsy (IGCNB) is a widely used and valuable clinical tool for tissue diagnosis of pediatric neuroblastoma. However, open surgical biopsy remains common practice even if children undergo more invasive and painful procedures. This review aims to determine the diagnostic accuracy and safety of IGCNBs in pediatric patients with neuroblastoma.
We conducted a systematic review of peer-reviewed original articles published between 1980 and 2023, by searching "pediatric oncology," "biopsy," "interventional radiology," and "neuroblastoma." Exclusion criteria were patients older than 18 years, studies concerning non-neurogenic tumors, case reports, and language other than English. Both the systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
A total of 533 abstracts articles were analyzed. Of these, eight retrospective studies met inclusion criteria (490 infants, 270 surgical biopsies [SB], 220 image-guided biopsies). Tissue adequacy for primary diagnosis (SB: n = 265, 98%; IGCNB: n = 199, 90%; p = .1) and biological characterization (SB: n = 186, 95%; IGCNB: n = 109, 89%; p = .15) was similar with both biopsy techniques, while intraoperative transfusion rate (SB: n = 51, 22%; IGCNB: n = 12, 6%; p = .0002) and complications (%) (SB: n = 58, 21%; IGCNB: n = 14, 6%; p = .005) were higher with surgical biopsy. Length of stay was similar in both groups; however, no additional data about concurrent diagnostic or treatment procedures were available in the analyzed studies.
IGCNB is a safe and effective strategic approach for diagnostic workup of NB and should be considered in preferance to SB wherever possible.
影像引导下的核心针活检（IGCNB）是一种广泛应用且有价值的临床工具，可用于儿童神经母细胞瘤的组织诊断。然而，即使儿童接受了更具侵袭性和痛苦的程序，开放性手术活检仍然是常见的做法。本综述旨在确定 IGCNB 在儿童神经母细胞瘤患者中的诊断准确性和安全性。
我们对 1980 年至 2023 年期间发表的同行评议原始文章进行了系统综述，检索词包括“儿科肿瘤学”、“活检”、“介入放射学”和“神经母细胞瘤”。排除标准为年龄大于 18 岁的患者、非神经源性肿瘤相关研究、病例报告以及非英文文献。系统综述和荟萃分析均按照系统评价和荟萃分析的首选报告项目（PRISMA）声明进行。
共分析了 533 篇摘要文章。其中，8 项回顾性研究符合纳入标准（490 例婴儿，270 例手术活检[SB]，220 例影像引导活检[IGCNB]）。两种活检技术的组织学诊断（SB：n=265，98%；IGCNB：n=199，90%；p=0.1）和生物学特征（SB：n=186，95%；IGCNB：n=109，89%；p=0.15）相似，但 SB 的术中输血率（SB：n=51，22%；IGCNB：n=12，6%；p=0.0002）和并发症发生率（SB：n=58，21%；IGCNB：n=14，6%；p=0.005）更高。两组的住院时间相似；然而，在分析的研究中没有关于同时进行的诊断或治疗程序的额外数据。
IGCNB 是 NB 诊断性评估的一种安全有效的策略方法，应尽可能优先考虑 SB。
