Ultrasonography-guided core-needle biopsy of lymphadenopathies suspected of lymphoma: Analysis on diagnostic efficacy and safety of 1000 front-line biopsies in a multicenter Italian study.

Autor: Picardi M; Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy., Giordano C; Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy., Vigliar E; Department of Public Health, Federico II University Medical School, Naples, Italy., Zeppa P; Department of Medicine and Surgery, Salerno University Medical School, Baronissi, Italy., Cozzolino I; Department of Mental and Physical Health and Preventive Medicine, University of Campania 'L. Vanvitelli', Naples, Italy., Pugliese N; Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy., Della Pepa R; Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy., Esposito M; Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy., Abagnale DP; Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy., Ciriello M; Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy., Muccioli-Casadei G; Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy., Troncone G; Department of Public Health, Federico II University Medical School, Naples, Italy., Russo D; Department of Advanced Biomedical Sciences, Federico II University Medical School, Naples, Italy., Mascolo M; Department of Advanced Biomedical Sciences, Federico II University Medical School, Naples, Italy., Varricchio S; Department of Advanced Biomedical Sciences, Federico II University Medical School, Naples, Italy., Accarino R; Department of Advanced Biomedical Sciences, Federico II University Medical School, Naples, Italy., Persico M; Department of General Surgery, Endocrinology, Orthopaedics, and Rehabilitations, Federico II University Medical School, Naples, Italy., Pane F; Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy.
Jazyk: angličtina
Zdroj: Hematological oncology [Hematol Oncol] 2023 Dec; Vol. 41 (5), pp. 817-827. Date of Electronic Publication: 2023 Jul 06.
DOI: 10.1002/hon.3204
Abstrakt: The reliability and safety of front-line ultrasonography guided core needle biopsy (UG-CNB) performed with specific uniform approach have never been evaluated in a large series of patients with lymphadenopathies suspected of lymphoma. The aim of this study was to assess the overall accuracy of UG-CNB in the lymph node histological diagnosis, using a standard reference based on pathologist consensus, molecular biology, and/or surgery. We retrospectively checked the findings concerning the application of lymph node UG-CNB from four Italian clinical units that routinely utilized 16-gauge diameter modified Menghini needle under power-Doppler ultrasonographic guidance. A data schedule was sent to all centers to investigate the information regarding techniques, results, and complications of lymph node UG-CNB in untreated patients over a 12-year period. Overall, 1000 (superficial target, n = 750; deep-seated target, n = 250) biopsies have been evaluated in 1000 patients; other 48 biopsies (4.5%), screened in the same period, were excluded because inadequate for a confident histological diagnosis. Most patients were suffering from lymphomas (aggressive B-cell non-Hodgkin lymphoma [aBc-NHL], 309 cases; indolent B-cell [iBc]-NHL, 279 cases; Hodgkin lymphoma [HL], 212 cases; and nodal peripheral T-cell [NPTC]-NHL, 30 cases) and 100 cases from metastatic carcinoma; 70 patients had non-malignant disorders. The majority of CNB results met at least one criterion of the composite reference standard. The overall accuracy of the micro-histological sampling was 97% (95% confidence interval: 95%-98%) for the series. The sensitivity of UG-CNB for the detection of aBc-NHL was 100%, for iBc-NHL 95%, for HL 93%, and for NPTC-NHL 90%, with an overall false negative rate of 3.3%. The complication rate was low (6% for all complications); no patient suffered from biopsy-related complications of grade >2 according to the Common Terminology Criteria for Adverse Events. Lymph node UG-CNB as mini-invasive diagnostic procedure is effective with minimal risk for the patient.
(© 2023 The Authors. Hematological Oncology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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