ABSTRAK
Pendahuluan: Biopsi jarum inti dianggap memiliki hasil akurasi yang samadengan biopsi terbuka dan telah menjadi prosedur rutin untuk menegakkandiagnosis lesi muskuloskeletal. Namun demikian uji diagnostik biopsi jarum intidi Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPN CM)belum dilaporkan. Tujuan dari analisis retrospektif ini adalah untuk mendapatkannilai ketepatan diagnosis biopsi jarum inti pada lesi muskuloskeletal.Metode: Dari Januari 2011 hingga Agustus 2015, semua pasien dengan lesi muskuloskeletal di RSUPN CM yang menjalani biopsi jarum inti dan eksisi tumor diidentifikasi dan diambil datanya. Ketepatan diagnosis dianalisis baik untukkesimpulan histopatologi maupun kesimpulan clinical pathology conference(CPC).Hasil: Sebanyak 86 sampel dikumpulkan dalam penelitian ini. Ketepatandiagnosis biopsi jarum inti dibandingkan dengan spesimen pasca eksisi adalah74,4%. Setelah dilakukan CPC, nilai ketepatan menjadi 83,7% dengan sensitivitas98%, spesifisitas 59%, NDP 87%, NDN 93% (p = 0.00). Ketepatan biopsi jaruminti setelah pulasan imunohistokimia naik menjadi 84,9% (p = 0,438). Ketepatanuntuk membedakan lesi jinak dan ganas adalah 97,1% (jinak) dan 82,7% (ganas)(p = 0.00). Ketepatan untuk membedakan lesi primer dan metastasis adalah 97,2%(primer) dan 85,7% (metastasis) (p = 0.00).Diskusi: Kami mendapatkan nilai ketepatan biopsi jarum inti yang sedikit lebihrendah karena dalam penelitian ini dituntut untuk membuat diagnosis sampaitingkat morfologi (ICD O dan ICD X). Namun demikian, dengan modalitas lainseperti imunohistokimia dan kesimpulan CPC, ketepatan menjadi meningkat.Ketepatan diagnosis untuk membedakan lesi jinak-ganas dan primer-metastasis tinggi. Biopsi jarum inti direkomendasikan untuk penegakkan diagnosis lesi muskuloskeletal.ABSTRACT
Introduction: Core needle biopsy is considered to have similar results with openbiopsy in accuracy and already become a routine procedure to establish thediagnosis of musculoskeletal lesion. However, diagnostic test of core needlebiopsy application in Cipto Mangunkusumo Hospital has not been reported.Therefore, the aim of this retrospective analysis was to attain the accuracy ofmusculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy andsubsequent tumour excision were indentified and enrolled. Diagnostic accuracywere calculated for both histopathology and clinical pathology conference (CPC)conclusion.Results: A total of 86 samples were indentified and enrolled in this study. Theaccuracy of core needle biopsy compared to subsequent excision is 74.4%. WithCPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%,PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguishprimary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p=0.00). Discussion: We found slightly inferior results for core needle biopsy accuracycompared to literature due to high specificity diagnosis obligatory (ICD O andICD X morphology) in our study. However, with other modalities such asimmunohistochemistry and CPC, the accuracy is increased. The accuracy todistinguish between benign vs malignant and primary vs metastatic lesion is high.Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions.;Introduction: Core needle biopsy is considered to have similar results with openbiopsy in accuracy and already become a routine procedure to establish thediagnosis of musculoskeletal lesion. However, diagnostic test of core needlebiopsy application in Cipto Mangunkusumo Hospital has not been reported.Therefore, the aim of this retrospective analysis was to attain the accuracy ofmusculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy andsubsequent tumour excision were indentified and enrolled. Diagnostic accuracywere calculated for both histopathology and clinical pathology conference (CPC)conclusion.Results: A total of 86 samples were indentified and enrolled in this study. Theaccuracy of core needle biopsy compared to subsequent excision is 74.4%. WithCPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%,PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguishprimary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p=0.00). Discussion: We found slightly inferior results for core needle biopsy accuracycompared to literature due to high specificity diagnosis obligatory (ICD O andICD X morphology) in our study. However, with other modalities such asimmunohistochemistry and CPC, the accuracy is increased. The accuracy todistinguish between benign vs malignant and primary vs metastatic lesion is high.Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions.;Introduction: Core needle biopsy is considered to have similar results with openbiopsy in accuracy and already become a routine procedure to establish thediagnosis of musculoskeletal lesion. However, diagnostic test of core needlebiopsy application in Cipto Mangunkusumo Hospital has not been reported.Therefore, the aim of this retrospective analysis was to attain the accuracy ofmusculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy andsubsequent tumour excision were indentified and enrolled. Diagnostic accuracywere calculated for both histopathology and clinical pathology conference (CPC)conclusion.Results: A total of 86 samples were indentified and enrolled in this study. Theaccuracy of core needle biopsy compared to subsequent excision is 74.4%. WithCPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%,PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguishprimary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p=0.00). Discussion: We found slightly inferior results for core needle biopsy accuracycompared to literature due to high specificity diagnosis obligatory (ICD O andICD X morphology) in our study. However, with other modalities such asimmunohistochemistry and CPC, the accuracy is increased. The accuracy todistinguish between benign vs malignant and primary vs metastatic lesion is high.Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions. |
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