目的:我们的目的是比较在开放腕管松解术中获得的腱鞘膜(TS)和腕横韧带(TCL)活检中淀粉样蛋白沉积发生率的差异。我们假设,当从同一患者获得两个样本时,TCL和TS之间淀粉样蛋白的发生率相似。
方法:所有主要,我们回顾了2022年1月至2023年9月期间接受淀粉样蛋白活检的选择性开放腕管松解术病例.由病理学家独立评估腱鞘和TCL标本以评估淀粉样蛋白。收集了人口统计数据,并比较了两种样品之间淀粉样蛋白沉积的发生率。协议统计,灵敏度,并计算了TCL的特异性,使用TS作为参考标准。
结果:总共196例符合1级(n=180)或2级(n=16)活检标准。48例因活检遗漏或实验室处理错误而被排除,留下148个案例可供分析。淀粉样蛋白沉积存在于148个(21%)TS样本中的31个和148个(22%)TCL样本中的33个中。总的来说,148例中,有138例(93%)的TS活检结果与TCL活检结果一致。在TCL和TS活检结果不同的10例中,6例患者有(+)TCL和(-)TS,4例患者在TS有淀粉样蛋白沉积,在TCL无沉积证据。TCL标本的敏感性和特异性分别为87%和95%,分别。阳性和阴性预测值分别为82%和97%,分别。
结论:对于接受活检的开放性腕管松解术的病例,在21%的TS标本和22%的TCL标本中发现淀粉样蛋白沉积。从同一患者获得的TS和TCL活检结果在93%的病例中一致。淀粉样蛋白的单源活检是一种合理的诊断方法。应进行未来的成本分析,以确定增加两个活检源以提高诊断准确性是否合理。
方法:预后II.
OBJECTIVE: Our purpose was to compare differences in the incidence of amyloid deposition in tenosynovium (TS) versus transverse carpal ligament (TCL) biopsies obtained during open carpal tunnel release. We hypothesized that the incidence of amyloid would be similar between TCL and TS when obtaining both specimens from the same patient.
METHODS: All primary, elective open carpal tunnel release cases that underwent
biopsy for amyloid between January 2022 and September 2023 were reviewed. Tenosynovial and TCL specimens were independently evaluated by a pathologist to assess for amyloid. Demographic data were collected, and incidence of amyloid deposition was compared between the two samples. Agreement statistics, sensitivity, and specificity were calculated for TCL, using TS as the reference standard.
RESULTS: A total of 196 cases met either Tier 1 (n=180) or Tier 2 (n=16)
biopsy criteria. Forty-eight cases were excluded for missed biopsies or laboratory processing errors, leaving 148 cases available for analysis. Amyloid deposition was present in 31 out of 148 (21%) TS specimens and 33 out of 148 (22%) TCL specimens. Overall, the results of the TS
biopsy agreed with TCL
biopsy in 138 out of 148 cases (93%). In the 10 cases for which the results of the TCL and TS
biopsy differed, six cases had (+) TCL and (-) TS, and four cases had amyloid deposition in TS without evidence of deposition in the TCL. Sensitivity and specificity values for the TCL specimen were 87% and 95%, respectively. Positive and negative predictive values were 82% and 97%, respectively.
CONCLUSIONS: For cases of open carpal tunnel release undergoing biopsy, amyloid deposition was noted in 21% of TS specimens and 22% of TCL specimens. Results of TS and TCL biopsies obtained from the same patient agreed in 93% of cases. Single-source
biopsy for amyloid represents a reasonable diagnostic approach. Future cost analyses should be performed to determine whether the addition of two biopsy sources to improve diagnostic accuracy is justified.
METHODS: Prognostic II.