The diagnostic value of core needle biopsy in cervical cancer: a
retrospective analysis
Abstract
Objective: To evaluate the accuracy, sensitivity, specificity, and
predictive value of preoperative core needle biopsy (CNB) assessment of
histological characteristics in primary cervical cancer. Setting:
Retrospective cohort study. Population: Women older than 18 with primary
cervical cancer enrolled in the prospective Leipzig School MMR study and
had CNBs taken before their operation. Methods: We reviewed 318 cases of
cervical carcinoma with available pathology reports from preoperative
CNB assessment and from final postoperative evaluation of the
hysterectomy specimen. Setting the postoperative comprehensive
pathological evaluation as reference, we analysed CNB assessment of
histological tumor characteristics. In addition, we performed
multivariable logistic regression to identify factors influencing the
accuracy in identifying lymphovascular space invasion (LVSI) and tumor
grade. Main outcome measures: Accuracy, sensitivity, specificity, and
predictive values of CNB assessment of histological tumor
characteristics and the variables influencing these. Results: CNB was
highly accurate in discriminating histological subtype. Sensitivity and
specificity were 98.8% and 89% for squamous cell carcinoma (SCC),
92.9% and 96.6% for adenocarcinoma (AC), 33.3% and 100% in
adenosquamous carcinoma respectively. Neuroendocrine carcinoma was
always recognized correctly. The accuracy of the prediction of
lymphovascular space invasion (LVSI) was 61.9% and was positively
influenced by tumor size in preoperative MRI and negatively influenced
by strong peritumoral inflammation. High tumor grade was diagnosed
accurately in 73.9% of cases and was influenced by histological tumor
type. Conclusions: CNB is an accurate sampling technique for
histological classification of cervical cancer and represents a
reasonable alternative to other biopsy techniques. Funding: “Stiftung
gynäkologische Onkologie” (non-profit-organization).