Background

Stereotactic needle biopsy remains the cornerstone for tissue diagnosis for tumors located in regions of the brain that are difficult to access through open surgery.

Objective

We perform a meta-analysis of the literature to examine the relation between number of samples taken during biopsy and diagnostic yield, morbidity and mortality.

Methods

We identified 2416 patients from 28 cohorts in studies published in PubMed database that studied stereotactic needle biopsies for tumor indications. Meta-analysis by proportions and meta-regression analyses were performed.

Results

On meta-analysis, the morbidity profile of the published needle biopsy studies clustered into three groups: studies that performed < 3 samples (n = 8), 3–6 samples (n = 13), and > 6 samples during biopsy (n = 7). Pooled estimates for biopsy related morbidity were 4.3%, 16.3%, and 17% for studies reporting < 3, 3–6, and > 6 biopsy samples, respectively. While these morbidity estimates significantly differed (p < 0.001), the diagnostic yields reported for studies performing < 3 biopsies, 3–6 samples, and > 6 samples were comparable. Pooled estimates of diagnostic yield for these three groups were 90.4%, 93.8%, and 88.1%, respectively. Mortality did not significantly differ between studies reporting differing number of samples taken during biopsy.

Conclusions

Our meta-analysis suggests that morbidity risk in needle biopsy is non-linearly associated with the number of samples taken. There was no association between the number of biopsies taken, and diagnostic yield or mortality.

中文翻译：

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临床结果与立体定向穿刺活检样本数量的关系：荟萃分析

背景

立体定向穿刺活检仍然是对位于通过开放手术难以进入的大脑区域的肿瘤进行组织诊断的基石。

客观的

我们对文献进行荟萃分析，以检查活检期间采集的样本数量与诊断率、发病率和死亡率之间的关系。

方法

我们在 PubMed 数据库中发表的研究中确定了来自 28 个队列的 2416 名患者，这些研究研究了立体定向针活检的肿瘤适应症。进行了按比例的荟萃分析和荟萃回归分析。

结果

在荟萃分析中，已发表的针刺活检研究的发病率分布分为三组：在活检期间进行 < 3 个样本 (n = 8)、3-6 个样本 (n = 13) 和 > 6 个样本的研究 (n = 7）。对于报告<3、3-6和>6个活检样本的研究，活检相关发病率的汇总估计分别为4.3%、16.3%和17%。虽然这些发病率估计值存在显着差异（p < 0.001），但报告的诊断率对于执行 < 3 个活检、3-6 个样本和 > 6 个样本的研究具有可比性。这三组的综合诊断率估计分别为 90.4%、93.8% 和 88.1%。报告活检期间采集的样本数量不同的研究之间的死亡率没有显着差异。

结论

我们的荟萃分析表明，穿刺活检的发病风险与采集的样本数量呈非线性相关。活检的数量与诊断率或死亡率之间没有关联。