Department of Imaging & Intervention, Chang Gung Memorial Hospital, 5 Fu Hsing Road, Kwei Shan, Taoyuan, Taiwan.
Lung Cancer. 2010 Feb;67(2):166-9. doi: 10.1016/j.lungcan.2009.04.007. Epub 2009 May 17.
To compare adequacy of tissue acquisition for EGFR DNA mutation analysis and the resulting complications in CT-guided lung biopsy cases with either 18-gauge or 20-gauge core biopsy needle.
Forty-seven patients with advanced staged non-small cell lung cancers who were failure-treated by conventional chemotherapy were retrospectively reviewed. All had received CT-guided core needle lung biopsy for histology diagnosis and freshly frozen for EGFR mutation analysis before targeted therapy. We compared the complications resulting from these CT-guided lung biopsies and the specimen assessment using 18-gauge (32 patients) or 20-gauge (15 patients) biopsy needle via 17-gauge or 19-gauge coaxial needle.
With an overall pneumothorax rate of 12.8%, pneumothorax occurred in 12.5% and 13.3% of patients by 17-gauge and 19-gauge coaxial needles respectively. The overall rate of hemoptysis was 6.4%, with 6.3% by 18-gauge biopsy needle and 6.6% by 20-gauge biopsy needle. Large peritumoral hemorrhage revealed only in 2 cases of those completed with 18-gauge biopsy needles. 18-gauge biopsy needle obtained larger specimens with heavier weight (average 10.15mg vs 9mg) and higher DNA concentration (average 47.13ng/ul vs 35.92ng/ul) than 20-gauge biopsy needle. Otherwise, the range of optical density (1.67-2.09) was more constant in the specimens by 20-gauge biopsy needles. Mutation demonstration was achieved for all samples.
CT-guided core needle biopsy is a feasible technique in acquisition of fresh cancer tissues for EGFR gene mutation analysis. The specimen is adequate for gene demonstration either using 18-gauge or 20-gauge tru-cut biopsy needles via 17-gauge or 19-gauge coaxial needles.
比较 18 号和 20 号活检针在 CT 引导下肺活检中获取组织用于 EGFR DNA 突变分析的充分性以及由此产生的并发症。
回顾性分析 47 例晚期非小细胞肺癌患者，这些患者在常规化疗失败后接受了 CT 引导下的核心针肺活检，以便进行组织学诊断，并在靶向治疗前进行新鲜冷冻 EGFR 突变分析。我们比较了使用 17 号和 19 号同轴针的 18 号（32 例）和 20 号（15 例）活检针进行 CT 引导下肺活检的并发症和标本评估。
气胸总发生率为 12.8%，17 号和 19 号同轴针的气胸发生率分别为 12.5%和 13.3%。总的咯血发生率为 6.4%，18 号活检针为 6.3%，20 号活检针为 6.6%。只有 2 例用 18 号活检针完成的病例出现较大的肿瘤周围出血。18 号活检针获得的标本较大，重量较重（平均 10.15mg 比 9mg），DNA 浓度较高（平均 47.13ng/ul 比 35.92ng/ul）。20 号活检针的标本光密度范围（1.67-2.09）更为恒定。所有样本均能进行突变检测。
CT 引导下的核心针活检是获取新鲜癌症组织进行 EGFR 基因突变分析的可行技术。使用 17 号和 19 号同轴针的 18 号和 20 号 tru-cut 活检针均可获得足够的标本进行基因检测。
