The Accuracy Of Core Needle Biopsy Of Renal Masses Analysis

ObjectiveIn this study we aim to assess the accuracy of core needle biopsy of renal forpredicting the tumor histological subtype and nuclear grade. Also we want to assessthe impact of different positions and different pin numbers on the core needle biopsyMethodsFrom July2002to October2013, prospectively collecting for renal tumorspecimens which are from radical or partial nephrectomy. Using16g automatic biopsygun to get specimens in the central region and the surrounding area of the mass. andcompare the pathological diagnosis of biopsy specimens with postoperativepathologic results in benign and malignant tumor type, tumor grade, and compared indifferent location of the tumor biopsy for pathological diagnosis and the influence ofthe puncture needle for several different effects on pathological diagnosis.Results1.52cases of specimens were collected, male30cases (57.7%), female22cases (42.3%)，with an average age of54.9years (36-79).Tumor average maximumdiameter is4.51cm (2-15cm). Biopsy specimens of benign and malignant diagnosisaccuracy rate is100%, and Kappa=100%. Compared with the postoperativepathological resules the consistency is better.Accuracy rate of histologic subtypediagnosis was96%,on the basis of postoperative pathology, Kappa=96%.Renal clearcell carcinoma and papillary carcinoma’s Fuhrman grade diagnostic accuracy rate is66.7%, on the basis of postoperative pathologic results. Kappa=66.7%. Theconsistency is general;In1997the WHO recommended new nuclear grade ofclassification standard.According to the new classification standards,the accuracyrate can reach80.6%, the Kappa=80.6%, the consistency is good.2. We obtain1specimen in the central area and obtain2specimens in thesurrounding area in one case using automatic biopsy gan. Eligible specimens represent the puncture qualified success. The central area of the tumor take one needlepuncture and the success rate is90.4%. Taking one needle in the central area of thetumor and two needle in the surrounding area,then the success rate is98.1%; thecentral area and the surrounding area drawn a total of three needle puncture thesuccess rate is100%.3. We comparae different results of the pathological diagnosis in the surroundingarea or in the center of the tumor,and fand that there is difference.ConclusionsCore needle biopsy can identify benign and malignant renal tumors and clearpathological type of renal masses, and it can achieve high consistency with thepostoperative pathological results, but the diagnosis accuracy rate of renal tumorFuhrman classification is not high; In accordance with the new nuclear gradingsystem classification,the accuracy rate can reach80.6%, it is high consistency withpostoperative pathologic results. The more number of puncture, the success ratehigher. Success rate of three needles puncture can reach100%. In different position ofthe renal tumor (central or surrounding area) puncture the pathological diagnosis isnot different.