Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
PLoS One. 2012;7(8):e42043. doi: 10.1371/journal.pone.0042043. Epub 2012 Aug 2.
A risk of tumor seeding after percutaneous needle biopsy has been reported in various organs, including the lung. This study retrospectively evaluated the proportion of ipsilateral pleural recurrence after computed tomography-guided needle biopsy (CTNB) in p-stage I lung cancer patients.
Of the 321 patients diagnosed with p-stage I lung cancer, 124 underwent CTNB before surgery, while 197 underwent non-CTNB procedures, including bronchoscopic biopsy in 188 patients and thoracoscopic wedge resection in 9. These patients were retrospectively analyzed.
While the tumor size was significantly larger in the non-CTNB group (25 ± 9 mm) in comparison to the CTNB group (19 ± 9 mm) (p<0.001), percentage of pleural, vascular, or lymphatic invasions were comparable between the two groups. Eight patients developed ipsilateral pleural recurrences, one (1%) in the CTNB group, and 7 (4%) in the non-CTNB group. Of these, 3 patients developed pleural recurrence only at first, 1 (1%) in the CTNB group, and 2 (1%) in the non-CTNB group. The differences in the proportions of these pleural recurrences between the 2 groups were not significant. Subgroup analyses by baseline characteristics such as tumor size, pT stage, or microscopic pleural invasion, showed that proportions of pleural recurrences in CTNB group were not high compared with non-CTNB group in each subgroup. Analysis of progression-free survival showed that recurrences in CTNB were not high compared with non-CTNB.
The pleural recurrence was not significantly increased after CTNB in p-stage I lung cancer patients in this particular study.
经皮穿刺活检后肿瘤种植的风险已在包括肺在内的各种器官中报道。本研究回顾性评估了Ⅰ期肺癌患者 CT 引导下经皮穿刺活检（CTNB）后同侧胸膜复发的比例。
在 321 例诊断为Ⅰ期肺癌的患者中，124 例行 CTNB 术前检查，197 例行非 CTNB 检查，包括 188 例支气管镜活检和 9 例胸腔镜楔形切除术。对这些患者进行回顾性分析。
非 CTNB 组（25 ± 9mm）肿瘤直径明显大于 CTNB 组（19 ± 9mm）（p<0.001），两组胸膜、血管或淋巴侵犯的比例相似。8 例患者发生同侧胸膜复发，CTNB 组 1 例（1%），非 CTNB 组 7 例（4%）。其中，3 例仅首次出现胸膜复发，CTNB 组 1 例（1%），非 CTNB 组 2 例（1%）。两组胸膜复发比例差异无统计学意义。按肿瘤大小、pT 分期或显微镜下胸膜侵犯等基线特征进行亚组分析，结果显示 CTNB 组各亚组胸膜复发比例均不高于非 CTNB 组。无进展生存分析显示 CTNB 组复发率并不高于非 CTNB 组。
在本研究中，Ⅰ期肺癌患者 CTNB 后胸膜复发率并未显著增加。
