ความแม่นยำของการตรวจชิ้นเนื้อในผู้ป่วยเนื้องอกของเนื้อเยื่ออ่อนโดยวิธีใช้เข็มเจาะตัดเปรียบเทียบกับวิธีผ่าตัดแบบเปิด

Abstract

Open biopsy is a standard diagnostic procedure to get tissue sample from soft tissue tumor however there  are many complications such as need hospitalization infection bleeding etc. Tru-cut needle biopsy is closed needle  biopsy technique which widely used and accepted. Many papers reported the accuracy up to 92% but their limitation  are most of the studying included bone soft tissue tumors and metastases cases Some papers are combine  Tru-cut and fine needle aspiration in the result. Objective: The purpose of our study is finding the accuracy of Tru-cut needle biopsy and open biopsy compare with definitive surgery as a gold standard and confined only soft tissue tumors. Materials and methods: The sample size from calculation is 52. All patients were admitted as an in-patient. Tru-cut biopsy (Allegiance healthcare) was performed and follows by open biopsy under anesthesia.  Definitive surgeries were performed afterward. All of the specimens from Tru-cut open biopsy and definitive  surgery were sent to pathologist for histological examination. The results then were compared and reported as a match or unmatched. Results: The result is 5 unmatched in Tru-cut needle biopsy and 1 unmatched in open biopsy.The results show 90.38% accuracy of Tru-cut needle biopsy and 98.37% accuracy of open  biopsy. The results as a screening test for soft tissue sarcoma are as following  Tru-cut group has 79.16% sensitivity  100% specificity100% positive predictive value (PPV) and 87.50% negative predictive value (NPV) whereas  open biopsy group has 95.83% sensitivity 100% specificity 100% PPV and 96.55% NPV.  The result for screening  lipoma is 100 percent in both Tru-cut group and open biopsy group. The results for screening liposarcomain  Tru-cut group are 57.00% sensitivity 100% specificity and PPV 93.75% NPV compare to 100% result in open biopsy  group. Discussion: The Tru-cut needle biopsy seem to be a good technique to approach the soft tissue tumor  due to very high specificity and PPV safe convenient and low cost.