目标:这个大,回顾性,多中心研究检查了MayoClinic在11年期间进行颞动脉活检的经验,以帮助形成指南,从而实现该技术的最佳性能。
方法:从所有三个梅奥诊所的所有患者中确定了病理记录(罗切斯特,MN;杰克逊维尔,FL;斯科茨代尔,AZ)在11年的时间里接受了颞动脉手术,从1994年1月1日至2004年12月31日。从每份报告中,我们提取了人口统计信息,活检中两侧切除的颞动脉的长度,和每个标本的病理结果。我们使用逻辑回归来评估活检阳性是否可能与以下因素相关:活检长度,年龄,性别,类型(单边vs.双边),和学习的年份。
结果:我们的数据集包括对MayoClinic的2539例患者进行的3817例颞动脉活检。总的来说,681例(27%)患者至少一侧活检阳性。均匀注意到活检长度对活检阳性没有显着影响。在进行双侧活检的603例患者中,43(7%)的初始活检为阴性,对侧为阳性结果。
结论:我们的结果支持可以推荐任何长度的活检,在我们研究的范围内,而不影响阳性率。此外,我们得出的结论是,如果单侧活检在冰冻切片上是阴性的,然后我们建议在对侧进行第二次活检,以避免可能的漏诊。关键点•我们的论文是对所有3个梅奥诊所校区的大型回顾性研究,调查了颞动脉活检长度与活检阳性率之间的关联。•我们还确定了进行双侧活检的价值,其中第一次活检在冷冻切片上是阴性的。•我们相信我们研究的力量是迄今为止文献中最大的活检样本量之一,包括3817次活检。•我们的研究的总和支持,我们发现活检阳性不是长度的函数,第二,双侧活检诊断的疾病高达7%,否则无法通过单侧方法发现。
OBJECTIVE: This large, retrospective, multicenter study examines the Mayo Clinic experience with temporal artery biopsies over an 11-year period to help form guidelines that would lead to optimal performance of the technique.
METHODS: Pathology records were identified from all patients at all three Mayo Clinic sites (Rochester, MN; Jacksonville, FL; and Scottsdale, AZ) who underwent temporal artery surgery over an 11-year period, from January 1, 1994, to December 31, 2004. From each report, we extracted demographic information, the length of the temporal artery removed in the biopsy from each side, and the pathologic findings in each specimen. We used logistic regression to assess whether biopsy positivity may be associated with the following factors: biopsy length, age, sex, type (unilateral vs. bilateral), and year of study.
RESULTS: Our data set included 3817 temporal artery biopsies performed on 2539 patients at Mayo Clinic. Overall, 681 patients (27%) had a positive biopsy on at least one side. Biopsy length was uniformly noted to have no significant effect on biopsy positivity. Of the 603 patients with a bilateral biopsy, 43 (7%) had a negative initial biopsy followed by a positive result on the contralateral side.
CONCLUSIONS: Our results support that one can recommend any length of biopsy, within the range our study, without affecting the rate of positivity. Furthermore, we conclude that if a unilateral biopsy is negative on frozen section, then we recommend a second biopsy on the contralateral side to avoid possible missed diagnoses. Key Points • Our paper is a large retrospective study over all 3 Mayo Clinic campuses investigating the association between temporal artery biopsy length and the positivity rate of biopsies. • We also determined the value of performing bilateral biopsies in which the first biopsy was negative on frozen section. • We believe the strength of our study is having one of the largest sample sizes of biopsies in the literature to date including 3817 biopsies. • The sum of our research supports that we found biopsy positivity is not a function of length and, second, bilateral biopsies diagnose up to 7% of disease not otherwise picked up by unilateral approaches.