In this retrospective study, 232 spleen biopsies from 218 patients with cancer were assessed. Biopsies resulting in hemorrhage requiring hospitalization, transfusion, or other interventions were compared with those that did not. The maximization of the Youden index helped determine the optimal systolic blood pressure (SBP) and platelet count thresholds. There were 15 (7%) major hemorrhages among 211 core biopsies. A multivariate logistic regression model showed that higher SBP, lower platelet count, and the lack of ultrasound guidance were independently associated with major hemorrhage (P < .05). The optimal SBP cutoff was 140 mm Hg, and the platelet count cutoff was 120,000 platelets/μL. In conclusion, the high major hemorrhage rate of 7% among percutaneous core spleen biopsies in patients with cancer may be mitigated by controlling SBP to <140 mm Hg and avoiding biopsy in patients with thrombocytopenia.

在这项回顾性研究中，评估了来自 218 名癌症患者的 232 份脾脏活检。将导致需要住院、输血或其他干预措施的出血的活检与没有的活检进行比较。Youden 指数的最大化有助于确定最佳收缩压 (SBP) 和血小板计数阈值。211 例核心活检中有 15 例 (7%) 大出血。多元逻辑回归模型显示，较高的 SBP、较低的血小板计数和缺乏超声引导与大出血独立相关（P< .05)。最佳 SBP 截止值为 140 mm Hg，血小板计数截止值为 120,000 血小板/μL。总之，通过将 SBP 控制在 <140 mmHg 并避免对血小板减少症患者进行活检，可以减轻癌症患者经皮脾脏活检中 7% 的高大出血率。