1. In bone and soft tissue biopsy, is it better to choose needle biopsy or incision biopsy? What is the reason?

There are two major options for bone and soft tissue biopsy methods: needle biopsy and incision biopsy. Specifically, needle biopsy is also divided into fine needle aspiration and coarse needle aspiration, and incision biopsy is also divided into excision biopsy and incision biopsy. In general, incisional biopsy is the gold standard because the reference standard for clinical research results on needle biopsy is incisional biopsy. Generally speaking, the incision biopsy method can obtain a large amount of tumor tissue and the quality of the specimen is higher, and the pathological diagnosis is generally better than the needle biopsy in terms of tissue sampling. However, incisional biopsy itself requires anesthesia and surgical operation, so the incidence of complications is slightly higher than that of Chunci biopsy, which is closely related to the clinical experience of doctors. The advantage of needle biopsy is that it is less invasive, but the disadvantage is that needle biopsy is sometimes inappropriate for specimens of osteogenic tumors. Because of the easy puncture point error, the possibility of not getting the real tumor is higher than that of incisional biopsy, so the possibility of misdiagnosis may be slight. High, of course, the literature says that the probability of misdiagnosis of the two is the same. Needle biopsy is more advantageous in the pelvis, deep parts of the human body, and anatomical parts where the biopsy is too traumatic. For example, in the pelvis or spine, most of the needle biopsy is more reasonable. Incisional biopsy is more reasonable in common sites. For osteogenic tumors, needle biopsy is slightly inappropriate, and incisional biopsy is better. In adipose-derived tumors, in fact, needle biopsy is generally unreliable, and excisional biopsy may be more clinically justified. There are well-known clinical institutions abroad, all of which use incisional biopsy in bone tumors to improve the accuracy and efficiency of diagnosis, which has its necessity and clinical needs. Needle biopsy and incision biopsy cannot be generalized clinically, and work needs to be carried out according to the actual situation of the patient.

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