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首页> 外文期刊>International journal of surgical pathology >Diagnostic Accuracy of Renal Mass Biopsy: An Ex Vivo Study of 100 Nephrectomy Specimens
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Diagnostic Accuracy of Renal Mass Biopsy: An Ex Vivo Study of 100 Nephrectomy Specimens

机译：肾脏肿块活检的诊断准确性：100份肾切除标本的体外研究

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摘要

We investigated the diagnostic accuracy of renal mass biopsy in an ex vivo model, as well as compared the agreement of the preoperative radiological diagnosis with the final pathologic diagnosis. Two 18-gauge needle-core and 2 vacuum-needle biopsies were performed ex vivo from the tumors of 100 consecutive patients undergoing radical nephrectomy between 2006 and 2010. The median tumor size was 5.5 cm. There was no significant difference with regard to cylinder length or tissue quality between the sampling methods. At least 1 of 4 needle cores contained diagnostic tissue in 88% of patients. Biopsy specimens identified clear cell (54%), papillary (13%), or chromophobe (5%) renal cell carcinoma; urothelial carcinoma (6%); oncocytoma (5%); liposarcoma (1%); metastatic colorectal carcinoma (1%); squamous cell carcinoma (1%); unclassified renal cell neoplasm (1%); and no tumor sampled (12%). The sensitivity of the biopsy for accurately determining the diagnosis was 88% (95% CI: 79% to 93%). The specificity was 100% (95% CI: 17% to 100%). Biopsy grade correlated strongly with final pathology (83.5% agreement). There was no difference in average tumor size in cases with the same versus higher grade on final pathology (5.87 vs 5.97; P = .87). Appraisal of tumor histology by radiology agreed with the pathologic diagnosis in 68% of cases. Provided that the biopsy samples the tumor tissue in a renal mass, pathologic analysis is of great diagnostic value in respect of grade and tumor type and correlates well with excisional pathology. This constitutes strong ground for increasingly used renal mass biopsy in patients considering active surveillance or ablation therapy.
机译：我们调查了离体模型中肾脏肿块活检的诊断准确性，并比较了术前放射学诊断与最终病理学诊断的一致性。在2006年至2010年之间，从100例接受根治性肾切除术的连续患者的肿瘤中进行了两次18口针芯活检和2根真空针活检。肿瘤中位大小为5.5厘米。在圆筒长度或组织质量方面，两种采样方法之间没有显着差异。在88％的患者中，至少有4个针芯中的1个包含诊断组织。活检标本鉴定出透明细胞（54％），乳头状癌（13％）或发色团（5％）肾细胞癌。尿路上皮癌（6％）;肿瘤细胞瘤（5％）;脂肪肉瘤（1％）;转移性大肠癌（1％）;鳞状细胞癌（1％）;未分类的肾细胞肿瘤（1％）;且未取样肿瘤（12％）。活检准确诊断的敏感性为88％（95％CI：79％至93％）。特异性为100％（95％CI：17％至100％）。活检等级与最终病理高度相关（83.5％一致）。在最终病理学上相同或较高等级的病例中，平均肿瘤大小无差异（5.87 vs 5.97; P = 0.87）。 68％的病例通过放射学评估肿瘤组织学与病理诊断相符。只要活检标本以肾脏肿块的形式采样肿瘤组织，病理学分析就其分级和肿瘤类型具有重大诊断价值，并且与切除病理学有很好的相关性。这为考虑积极监测或消融治疗的患者越来越多地使用肾脏肿块活检奠定了坚实的基础。

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