Schweitzer M E, Gannon F H, Deely D M, O'Hara B J, Juneja V
Department of Radiology Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
AJR Am J Roentgenol. 1996 Feb;166(2):415-8. doi: 10.2214/ajr.166.2.8553958.
Although core biopsy is the standard for percutaneous bone biopsy in most other organs aspiration biopsy is frequently performed. We prospectively evaluated 138 patients with skeletal lesions, performing both core and aspiration biopsies to determine if these techniques have a complementary role.
Over a 2-year period, 138 consecutive patients underwent skeletal biopsy. In each patient, two or three histologic cores were obtained percutaneously using standard techniques followed by a single aspiration pass with a 22-gauge spinal needle and 20 cc of negative pressure. Histologic and cytologic evaluations of cores and aspirates were interpreted according to usual pathologic and cytologic criteria. Results were classified as matches (positive or negative), mismatches (aspiration or core only positive), mismatches (either aspiration or core more specific), insufficient samples, inaccurate diagnoses, and both false-negative.
Twenty-eight patients had specific neoplasms diagnosed on both core and aspiration biopsy, and 40 patients were negative on both. The diagnosis was made only by core in 17 and only by aspiration in 11. Core was more specific in 11, and aspiration was more specific in seven. There were three insufficient cores and 18 insufficient aspiration specimens. One false-negative result was seen by both techniques, and the cytology of two aspiration biopsies was misinterpreted.
A complementary role exists for aspiration and core skeletal biopsy, and we suggest both should be routinely performed.
尽管在大多数其他器官中，粗针活检是经皮骨活检的标准方法，但细针穿刺抽吸活检也经常被采用。我们对138例骨骼病变患者进行了前瞻性评估，同时进行粗针活检和细针穿刺抽吸活检，以确定这些技术是否具有互补作用。
在两年时间里，138例连续患者接受了骨骼活检。对每位患者，采用标准技术经皮获取两到三个组织学粗针样本，随后用22号脊椎穿刺针单次穿刺抽吸并施加20毫升负压。根据常规病理和细胞学标准对粗针样本和抽吸样本进行组织学和细胞学评估。结果分为匹配（阳性或阴性）、不匹配（仅抽吸或粗针阳性）、不匹配（抽吸或粗针更具特异性）、样本不足、诊断不准确以及两者均为假阴性。
28例患者经粗针活检和细针穿刺抽吸活检均诊断出特定肿瘤，40例患者两者均为阴性。仅通过粗针活检确诊的有17例，仅通过细针穿刺抽吸活检确诊的有11例。粗针活检在11例中更具特异性，细针穿刺抽吸活检在7例中更具特异性。有3个粗针样本不足，18个细针穿刺抽吸样本不足。两种技术均出现1例假阴性结果，且有2例细针穿刺抽吸活检的细胞学结果被误判。
细针穿刺抽吸活检和粗针骨骼活检存在互补作用，我们建议两者都应常规进行。
