Surgical Site Cytology to Diagnose Spinal Lesions
Patients with new-onset malignant spinal lesions often have an urgent need for local spine intervention and systemic therapy. For optimal management, it is crucial to diagnose the underlying disease as quickly and reliably as possible. The aim of our current study was to determine the feasibility, s...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/2/310 |
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| author | Leon-Gordian Koepke Annika Heuer Martin Stangenberg Marc Dreimann Lutz Welker Carsten Bokemeyer André Strahl Anne Marie Asemissen Lennart Viezens |
| author_facet | Leon-Gordian Koepke Annika Heuer Martin Stangenberg Marc Dreimann Lutz Welker Carsten Bokemeyer André Strahl Anne Marie Asemissen Lennart Viezens |
| author_sort | Leon-Gordian Koepke |
| collection | DOAJ |
| description | Patients with new-onset malignant spinal lesions often have an urgent need for local spine intervention and systemic therapy. For optimal management, it is crucial to diagnose the underlying disease as quickly and reliably as possible. The aim of our current study was to determine the feasibility, sensitivity, specificity, and diagnostic certainty of complementary cytological evaluation of spinal lesions suspected of malignancy. In 44 patients, we performed histopathological biopsies and in parallel cytologic preparations from the malignant site. Cytological smears were prepared and stained for May-Grunwald and Giemsa. Bone biopsies were histopathologically analyzed according to the existing standard-of-care practices. In 42 of 44 cases (95%), a cytological sample was successfully obtained. In 40 cases (95.2%, Cohen’s kappa: 0.77), the cytological diagnosis agreed with the histological diagnosis regarding the identification of a malignant lesion. This resulted in a sensitivity of 97% and a specificity of 80% as well as a diagnostic safety of 95%. Cytological analysis in the context of spinal surgery proved sufficient to establish a diagnosis of malignancy or its exclusion, expanding the existing diagnostic spectrum. Furthermore, implementation of this process as a routine clinical diagnostic might shorten the time to diagnosis and improve the treatment of this vulnerable patient group. |
| first_indexed | 2024-03-09T22:12:35Z |
| format | Article |
| id | doaj.art-a7c36625e3824c05a239b4abcff29af8 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T22:12:35Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-a7c36625e3824c05a239b4abcff29af82023-11-23T19:29:54ZengMDPI AGDiagnostics2075-44182022-01-0112231010.3390/diagnostics12020310Surgical Site Cytology to Diagnose Spinal LesionsLeon-Gordian Koepke0Annika Heuer1Martin Stangenberg2Marc Dreimann3Lutz Welker4Carsten Bokemeyer5André Strahl6Anne Marie Asemissen7Lennart Viezens8Department of Trauma and Orthopedic Surgery, Division of Spine Surgery, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, GermanyDepartment of Trauma and Orthopedic Surgery, Division of Spine Surgery, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, GermanyDepartment of Trauma and Orthopedic Surgery, Division of Spine Surgery, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, GermanyDepartment of Trauma and Orthopedic Surgery, Division of Spine Surgery, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, GermanyInstitute of Pathology with the Sections Molecular Pathology and Cytopathology, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, GermanyDepartment of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald University Cancer Center, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, GermanyDepartment of Trauma and Orthopedic Surgery, Division of Orthopedics, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, GermanyDepartment of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald University Cancer Center, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, GermanyDepartment of Trauma and Orthopedic Surgery, Division of Spine Surgery, University Medical Center Hamburg Eppendorf, Martinistraße 52, D-20246 Hamburg, GermanyPatients with new-onset malignant spinal lesions often have an urgent need for local spine intervention and systemic therapy. For optimal management, it is crucial to diagnose the underlying disease as quickly and reliably as possible. The aim of our current study was to determine the feasibility, sensitivity, specificity, and diagnostic certainty of complementary cytological evaluation of spinal lesions suspected of malignancy. In 44 patients, we performed histopathological biopsies and in parallel cytologic preparations from the malignant site. Cytological smears were prepared and stained for May-Grunwald and Giemsa. Bone biopsies were histopathologically analyzed according to the existing standard-of-care practices. In 42 of 44 cases (95%), a cytological sample was successfully obtained. In 40 cases (95.2%, Cohen’s kappa: 0.77), the cytological diagnosis agreed with the histological diagnosis regarding the identification of a malignant lesion. This resulted in a sensitivity of 97% and a specificity of 80% as well as a diagnostic safety of 95%. Cytological analysis in the context of spinal surgery proved sufficient to establish a diagnosis of malignancy or its exclusion, expanding the existing diagnostic spectrum. Furthermore, implementation of this process as a routine clinical diagnostic might shorten the time to diagnosis and improve the treatment of this vulnerable patient group.https://www.mdpi.com/2075-4418/12/2/310spinal neoplasmsbiopsybone marrowspinecytological techniquestandard of care |
| spellingShingle | Leon-Gordian Koepke Annika Heuer Martin Stangenberg Marc Dreimann Lutz Welker Carsten Bokemeyer André Strahl Anne Marie Asemissen Lennart Viezens Surgical Site Cytology to Diagnose Spinal Lesions Diagnostics spinal neoplasms biopsy bone marrow spine cytological technique standard of care |
| title | Surgical Site Cytology to Diagnose Spinal Lesions |
| title_full | Surgical Site Cytology to Diagnose Spinal Lesions |
| title_fullStr | Surgical Site Cytology to Diagnose Spinal Lesions |
| title_full_unstemmed | Surgical Site Cytology to Diagnose Spinal Lesions |
| title_short | Surgical Site Cytology to Diagnose Spinal Lesions |
| title_sort | surgical site cytology to diagnose spinal lesions |
| topic | spinal neoplasms biopsy bone marrow spine cytological technique standard of care |
| url | https://www.mdpi.com/2075-4418/12/2/310 |
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