Diagnostic Efficacy of Trephine Biopsy and Core Biopsy of Bone and Soft Tissue Tumors

Abstract

Verification of pathomorphological diagnosis is a key stage in selection of treatment tactics in patients with neoplasms. Understanding of the nature of pathological process is especially important in context of primary tumors of the bones, soft tissues and metastases as despite active development of diagnostic techniques, they do not allow to obtain full information on histological nature of the tissues, differentiation grade, as well as molecular and genetic characteristics of the tumor. These data are associated with selection of optimal treatment tactics at every stage and disease prognosis. The optimal approach to obtaining histological materials in tumor of the bones and soft tissues are radiologically guided (X-ray, computed tomography and magnetic resonance imaging) trephine biopsy or ultra-sound-guided core biopsy.Aim. To determine information value of trephine and core biopsies of neoplasms of the bones and soft tissues of various locations, identify mistakes during manipulation affecting results of morphological diagnosis.Materials and methods. Between 2015 and 2023 at the Russian Scientific Center of Roentgenoradiology, 788 patients aged 18–85 years (380 men, 408 women) underwent 602 trephine biopsies and 248 core biopsies (n = 850) of neo-plasms of the soft tissues and bones of various locations. Absence of informational value of morphological study required repeat trephine biopsies in 19 patients, core biopsies in 2 patients, open biopsies in 13 patients.Results. Informational value of trephine biopsy of the bones was 90.5 % (long bones – 96.8 %, flat bones – 91.6 %, spine bones – 82.1 %), core biopsy of the soft tissues 98.8 %. Sufficient amount of material for immunohistochemical testing was obtained in 89 % biopsies. Interventions in cases of bone neoplasms were performed using CT (computed tomography) navigation; for core biopsies of the soft tissues, ultrasound was used. Absence of informational value in trephine bio psies was caused by insufficient amount of material (48 (7.97 %) cases), retrieval of trephine biopsy from the area of tumor necrosis (4 (0.67 %) cases), incorrect selection of access (4 (0.67 %) cases) and needle type (1 (0.17 %) case).Conclusion. Results of analysis of trephine and core biopsy data of bone and soft tissue neoplasms showed high information value, which is supported by literature data. This allows to consider these methods of histological material retrieval the “golden standard” of bone and soft tissue tumor diagnosis.