Comparative study of diagnostic accuracy between close needle biopsy and open incisional biopsy in musculoskeletal sarcoma
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Title Comparative study of diagnostic accuracy between close needle biopsy and open incisional biopsy in musculoskeletal sarcoma
Creator Phutsapong Srisawat
Contributor Taweechai Tejapongvorachai
Publisher Chulalongkorn University
Publication Year 2555
Keyword Musculoskeletal system -- Cancer -- Diagnosis, Needle biopsy, ระบบกล้ามเนื้อและโครงกระดูก -- มะเร็ง -- การวินิจฉัยโรค, การตัดชิ้นเนื้อด้วยการเจาะ
Abstract Objective: In this study, we purpose to study the diagnostic accuracy and other diagnostic values (diagnostic yield, error, complication) of CNB without real-time image-guidance in out-patient clinic by comparing with open incisional biopsy in musculoskeletal sarcoma patients. Methods: We retrospectively reviewed the biopsy cases of sarcoma patients since 2002-2011 from medical records and histopathology database. The diagnostic accuracy in 4 aspects of histopathology: nature (benign or malignant), specific diagnosis, histological type, and histological grade between 2 methods were compared statistically, the gold standard were the histopathology from resected specimens while definite surgery and information of clinicoradiographic/laboratory by clinical course. The other diagnostic values (diagnostic yield, error, complication) were also compared between both methods. Results: There were 200 cases (open incisional biopsy 105 cases and CNB 95 cases). The diagnostic accuracies of open incisional biopsy were 97.14% for nature, 89.52% for specific diagnosis, 89.52% for histological type, 88.57% for histological grade and the diagnostic accuracies of CNB were 96.84%, 89.47%, 88.42%, 86.32% respectively. There were no statistically significant different between 2 methods in all histological aspects (nature; P-value = 0.901 95%CI = -0.432 to 0.380, specific diagnosis; P-value = 0.991 95%CI = -0.227 to 0.224, histological type P- value = 0.803 95%CI = -0.250 to 0.193, and histological grade; P-value = 0.63 95%CI = -0.261 to 0.158). The diagnostic yields of both methods were 98.13% for open incisional biopsy, 97.94% for CNB. It was no statistically significant different also as shown in table 6 (P-value = 0.919 95%CI = -0.469 to 0.520). There were 6 cases (3%) for overall major errors, 3 cases (2.86%) for open incisional biopsy and 3 cases (3.16%) for CNB. There were 18 cases (9%) for minor errors, 9 cases (8.57%) for open incisional biopsy and 9 cases (9.47%) for CNB. There was no related biopsy complication in both methods. Conclusion: The office-based CNB for diagnosis musculoskeletal sarcoma can achieve the acceptable high diagnostic accuracy rates comparing with the open incisional biopsy.
URL Website cuir.car.chula.ac.th
Chulalongkorn University

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