摘要
目的:分析合并病理性骨折的上肢骨肿瘤穿刺活检结果,对可能的影响因素进行分析。方法:分析2015年1月至2019年12月收治的合并病理性骨折的上肢骨肿瘤患者,入选标准为患者行穿刺活检并接受了最终手术治疗,获得了穿刺活检及术后2次病理检查。符合入选标准的共77例,男55例,女22例;年龄5~88岁,中位年龄27岁;肿瘤位于肱骨67例,桡骨8例,尺骨2例。穿刺活检与最终诊断的疾病性质(良恶性)、诊断病名均一致为“正确”,疾病性质正确而诊断病名不一致则为“支持”,穿刺活检诊断的疾病性质错误则定为诊断“错误”。分析穿刺活检的准确性和影响因素。结果:穿刺活检正确63例(81.8%),支持14例(18.2%),错误0例。将患者的性别、年龄、部位、骨折是否移位、肿瘤的骨破坏类型(成骨或溶骨)、有无软组织肿块、病灶内有无液性区域对穿刺活检正确性的影响进行统计学分析,肿瘤有软组织肿块时穿刺活检正确率显著提高(P<0.05),病灶内有液性区域时正确率下降(P<0.05)。结论:穿刺活检对合并病理性骨折的上肢骨肿瘤诊断准确性高,活检取材时选择有软组织肿块区域能提高诊断准确性。
Objective:To analyze the results of percutaneous core needle biopsy for bone tumors in upper limbs with pathologic fracture and to find the possible factors that could impact the results.Methods:The including criteria for this study was the patients who had received percutaneous core needle biopsy and definitive surgery,whose tumor was located at upper limb with pathologic fracture.From January 2015 to December 2019,seventy-seven patients were enrolled.There were 55 males and 22 females.The median age was 27 years old(range:5 to 88 years old).The tumor located at humerus in 67 cases,radius in 8 cases and ulna in 2 cases.If the pathologic diagnosis of core needle biopsy was the same with the definitive surgery,it was defined as"correct".If the pathologic diagnosis of biopsy for benign or malignant was right but the exact diagnostic name was not the same with definitive surgery,it was defined as"supportive".If the pathologic diagnosis of biopsy for benign or malignant was not correct,it was defined as"wrong".We retrospectively analyzed the accuracy and impact factors for core needle biopsy.Results:The result was"correct"in 63 cases(81.8%),"supportive"in 14 cases(18.2%),and"wrong"in 0 cases.We analyzed the gender,age,location,fracture displacement,the destroyed type for bone tumor,soft tissue mass,fluid area in the tumor as the factors.The results showed the rate for"correct"was significantly higher when the tumor had soft tissue mass(P<0.05)and lower when the fluid area existed inside the tumor(P<0.05).Conclusion:The accuracy of percutaneous core needle biopsy for upper limb bone tumor with pathologic is high and acceptable.The biopsy chosen the soft tissue mass area can increase the accuracy.
作者
邓志平
赵海涛
孙扬
金韬
丁宜
牛晓辉
DENG Zhi-ping;ZHAO Hai-tao;SUN Yang;JIN Tao;DING Yi;NIU Xiao-hui(Department of Orthopaedic Oncology Surgery,Jishuitan Hospital,Beijing 100035,China)
出处
《中国骨伤》
CAS
CSCD
2021年第6期527-530,共4页
China Journal of Orthopaedics and Traumatology
关键词
病理性骨折
骨肿瘤
穿刺活检
Pathological fracture
Bone tumor
Core needle biopsy
