Fontaine-Delaruelle C, Souquet P-J, Gamondes D, Pradat E, de Leusse A, Ferretti G R, Couraud S
Service de pneumologie aiguë spécialisée et oncologie thoracique, hospices civils de Lyon, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Faculté de médecine Lyon Sud, université Lyon 1, 69600 Oullins, France.
Service de pneumologie aiguë spécialisée et oncologie thoracique, hospices civils de Lyon, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; EMR 3738, ciblage thérapeutique en oncologie, faculté de médecine Lyon Sud, université Lyon 1, 69600 Oullins, France.
Rev Pneumol Clin. 2017 Apr;73(2):61-67. doi: 10.1016/j.pneumo.2016.12.001. Epub 2017 Jan 4.
CT-guided transthoracic core-needle biopsy (TTNB) is frequently used for the diagnosis of lung nodules. The aim of this study is to describe TTNBs' complications and to investigate predictive factors of complications.
All consecutive TTNBs performed in three centers between 2006 and 2012 were included. Binary logistic regression was used for multivariate analysis.
Overall, 970 TTNBs were performed in 929 patients. The complication rate was 34% (life-threatening complication in 6%). The most frequent complications were pneumothorax (29% included 4% which required chest-tube) and hemoptysis (5%). The mortality rate was 0.1% (n=1). In multivariate analysis, predictive factor for a complication was small target size (AOR=0.984; 95% CI [0.976-0.992]; P<0.001). This predictive factor was also found for occurrence of life-threatening complication (AOR=0.982; [0.965-0.999]; P=0.037), of pneumothorax (AOR=0.987; [0.978-0.995]; P=0.002) and of hemoptysis (AOR=0.973; [0.951-0.997]; P=0.024).
One complication occurred in one-third of TTNBs. The proportion of life-threatening complication was 6%. A small lesion size was predictive of complication occurrence.
CT引导下经胸芯针活检（TTNB）常用于肺结节的诊断。本研究旨在描述TTNB的并发症并探究并发症的预测因素。
纳入2006年至2012年在三个中心进行的所有连续TTNB。采用二元逻辑回归进行多变量分析。
总体而言，929例患者共进行了970次TTNB。并发症发生率为34%（6%为危及生命的并发症）。最常见的并发症是气胸（29%，其中4%需要胸腔置管）和咯血（5%）。死亡率为0.1%（n = 1）。多变量分析显示，并发症的预测因素是目标病灶较小（比值比[AOR]=0.984；95%置信区间[CI][0.976 - 0.992]；P<0.001）。对于危及生命的并发症（AOR = 0.982；[0.965 - 0.999]；P = 0.037）、气胸（AOR = 0.987；[0.978 - 0.995]；P = 0.002）和咯血（AOR = 0.973；[0.951 - 0.997]；P = 0.024），也发现了这一预测因素。
三分之一的TTNB发生了一种并发症。危及生命的并发症比例为6%。病灶较小是并发症发生的预测因素。
