A biopsy is a typical medical test performed by a surgeon, an interventional radiologist, or an interventional cardiologist involving the extraction of sample or tissue cells for examination to determine the presence or extent of the disease. These tissues are generally examined under a microscope by a pathologist, and can also be chemically analyzed. When all lumps or suspicious areas are removed, this procedure is called excisional biopsy . An incisional biopsy or core biopsy takes a partial sample of abnormal tissue without attempting to remove all lesions or tumors. When a tissue or fluid sample is removed with a needle in such a way that the cells are removed without preserving the histologic architecture of tissue cells, this procedure is called needle aspiration biopsy. Biopsy is most often done to determine the possibility of cancer and inflammation conditions.
Video Biopsy
Medical use
Cancer
When cancer is suspected, various biopsy techniques can be applied. An excisional biopsy is an attempt to remove all lesions. When the specimen is evaluated, other than the diagnosis, the amount of tissue not involved in the lesion, the limit of surgery from the specimen is examined to see if the disease has spread beyond the biopsied area. "Remove margin" or "negative margin" means no illness is found on the edge of the biopsy specimen. "Positive margin" means the disease is found, and wider excision may be necessary, depending on the diagnosis.
When intact removal is not indicated for various reasons, tissue slices may be taken in incisional biopsy . In some cases, samples can be collected by devices that "bite" the sample. A variety of needle sizes may collect tissue in the lumen ( core biopsy ). Small diameter needles collect cell and cell clusters, fine needle aspiration biopsy.
Pathological examination of biopsy can determine whether the lesion is benign or malignant, and may help distinguish between different types of cancer. In contrast to a biopsy that only samples the lesion, a larger excisional specimen called resection may come to the pathologist, usually from a surgeon trying to eradicate a known lesion from a patient. For example, a pathologist will examine a mastectomy specimen, even if a previous nonexicitional breast biopsy has established a diagnosis of breast cancer. Full specimen examination of the mastectomy will confirm the exact nature of the cancer (tumor subclassification and histologic "gradation") and reveal the extent of its spread (pathological "staging").
Liquid biopsy
There are two types of liquid biopsies (which are not actually biopsy because they are blood tests that do not require tissue biopsy): circulating tumor cell test or cell-free tumor DNA testing. This method provides a non-invasive alternative to repeat invasive biopsies to evaluate mutations in cancer and plan individual care. In addition, since cancer is a heterogeneous genetic disease, and excisional biopsy only provides snapshots at a time when some rapid and dynamic genetic changes occur in tumors, liquid biopsies provide several advantages over genome-based biopsy tissue testing. In addition, excisional biopsy is invasive, can not be used repeatedly, and is not effective in understanding the dynamics of tumor development and metastasis. By detecting and measuring genomic changes in cell-free CTC and DNA in the blood, a liquid biopsy can provide real-time information on the tumor development stage, the effectiveness of treatment, and the risk of metastatic cancer. The development of this technology could make it possible to diagnose and manage cancer from recurrent blood tests rather than from traditional biopsies.
Circulating tumor cell test is being developed by Epic Sciences. Tests analyzing tumor cell circulation (CTC) Individual CTC analyzes show high levels of heterogeneity seen at single cell levels for protein expression and protein localization and CTC reflects primary biopsy and changes seen on metastatic sites.
DNA cell-free cell tumor analysis (cfDNA) has an advantage over circulating tumor cell tests that there are about 100 times more cell-free DNA than there is DNA in circulating tumor cells. These tests analyze the tumor DNA fragments of tumor cells that are constantly shed by tumors into the bloodstream. Companies offering cfDNA generation sequencing testing include Personal Genome Diagnostics and Guardant Health. These tests move into widespread use when tissue biopsy has insufficient material for DNA testing or when it is unsafe to perform invasive biopsy procedures, according to a recent report on more than 15,000 advanced cancer patients ranked by Guardant Health test.
A 2014 study of blood from 846 patients with 15 different cancer types in 24 institutions was able to detect the presence of cancer DNA in the body. They found tumor DNA in the blood of more than 80 percent of patients with metastatic cancer and about 47 percent of those with localized tumors. This test does not show tumor sites or other information about tumors. The test does not produce false positives.
Such tests may also be useful for assessing whether malignant cells persist in patients whose tumors have been surgically removed. Up to 30 percent is expected to recur because some tumor cells remain. Initial studies identified about half the patients who then relapsed again, again without false positives.
Another potential use is to track specific DNA mutations that move the tumor. Many new cancer drugs block certain molecular processes. Such tests may allow for easier targeting of the tumor.
Pre-cancerous conditions
For easily detectable and accessible sites, any suspicious lesions may be assessed. Initially, this is a skin or a superficial mass. X-rays, then CT, MRI, and ultrasound together with endoscopically expanded range.
Inflammatory conditions
Biopsy in the temporal artery is often performed for alleged vasculitis. In inflammatory bowel disease (Crohn's disease and ulcerative colitis), biopsy is often used to assess disease activity and to assess changes that precede malignancy.
Biopsy specimens are often taken from the part of the lesion when the cause of the disease is uncertain or broad or the exact character is questionable. Vasculitis, for example, is usually diagnosed in a biopsy.
- Kidney disease: Biopsy and fluorescence microscopy are key in the diagnosis of changes in kidney function. Immunofluorescence plays an important role in the diagnosis of Crescentic glomerulonephritis.
- Infectious diseases: Enlarged lymph nodes may be caused by various infectious or autoimmune diseases.
- Metabolic Diseases: Some conditions affect the whole body, but certain sites are selectively biopsied because they are easily accessible. Amyloidosis is a condition in which degraded proteins accumulate in body tissues. To make a diagnosis, gingiva.
- Transplantation: A transplant organ biopsy is performed to determine that they are not rejected or that the disease that requires transplantation does not reoccur.
- Fertility: Testicular biopsy is used to evaluate male fertility and find out possible causes of infertility, eg. when sperm quality is low, but hormone levels are still within the normal range.
Maps Biopsy
Biased site
Analysis of biopsied material
After the biopsy is performed, tissue samples removed from the patient are sent to the pathology laboratory. A pathologist specializes in diagnosing diseases (such as cancer) by examining the tissue under a microscope. When the laboratory (see Histology) receives a biopsy sample, the tissue is processed and very thin tissue slices are removed from the sample and attached to a glass slide. Any remaining tissue is stored for use in subsequent studies, if necessary. Slide with embedded tissue is treated with a dye that stains the tissue, allowing individual cells in the tissue to be seen more clearly. This slide is then given to a pathologist, who examines the tissue under a microscope, looking for abnormal findings. The pathologist then prepares a report that lists the abnormal or important findings of the biopsy. This report was sent to a doctor who initially performed a biopsy on the patient.
History
Abulcasis Arabic (1013-1107) developed one of the earliest diagnostic biopsies. He uses a needle to stab the goiter and then mark the material.
Etymology
The term biopsy reflects the Greek words ???? bios , "life," and ???? opsis , "a scene."
French dermatologist Ernest Besnier introduced the word biopsie to the medical community in 1879.
See also
- Intervention radiology
References
External links
- Mybiopsyinfo.com - What is a biopsy? How is the biopsy done? This website provides you with answers to these questions and many other questions.
- MyBiopsy.org - Link to video. Information on biopsy results for patients. This site is created by a pathologist, a doctor who diagnoses cancer and other diseases by looking at a biopsy under a microscope.
- RadiologyInfo - Radiology information source for patients: Biopsy
Source of the article : Wikipedia
0 Comments