An Interinstitutional Review of the Value of FNAB in Pediatric Oncology in Resource-Limited Countries

作者:Razack Rubina*; Michelow Pamela; Leiman Gladwyn; Harnekar Anwari; Poole Janet; Wessels Glynn; Hesseling Peter; Stefan Cristina; Louw Mercia; Schubert Pawel T; Clarke Herchel; Wright Colleen A
来源:Diagnostic Cytopathology, 2012, 40(9): 770-776.
DOI:10.1002/dc.21624

摘要

Fine-needle aspiration biopsy (FNAB) has been widely accepted as a reliable diagnostic modality in the general pediatric population, but its role in pediatric oncology still remains elusive. With new treatment protocols subscribing to preoperative chemotherapy, the need for a quick, minimally invasive, and accurate diagnostic procedure has arisen. This study assesses the feasibility of FNAB in childhood malignancies to render a specific diagnosis on which treatment can be initiated. An 11-year retrospective study was done on FNABs in patients 19 years and under referred for clinically malignant mass lesions. Cases were confirmed with histology, immunocytochemistry, flow cytometry, or clinical follow-up. Of the 357 patients referred for FNABs, 36 patients were lost to follow-up and 31 FNABS were inadequate. A total of 290 cases were included in the study, of which 68 (23%) cases were benign and 222 (77%) were malignant. The most frequently occurring tumors were nephroblastoma (68), non-Hodgkin%26apos;s lymphoma (39), rhabdomyosarcoma (22), Hodgkin%26apos;s lymphoma (22), and neuroblastoma (22). The sensitivity of the procedure for neoplasia was 96.6%, the specificity 97.0%, positive predictive value 99.0%, and negative predictive value 90.1%, with a diagnostic accuracy of 96.7%. The ability of FNAB to enable a specific diagnosis to be made, that is correct and accurate subtyping of the tumor on which chemotherapy or radiotherapy could be commenced was 75.7%. This study shows that FNAB can be used with confidence to confirm malignancy in children. With clinicoradiological correlation and the aid of ancillary techniques, FNAB allows a rapid and accurate preoperative diagnosis for definitive therapy commencement in most cases. Diagn. Cytopathol. 2012;40:770-776.

  • 出版日期2012-9