Allergy and Respiratory Medicine, Okayama University Hospital, 2-5-1, Kita-ku, Shikata-cho, Okayama City, Okayama, Japan.
Center for Clinical Oncology, Okayama University Hospital, 2-5-1, Kita-ku, Shikata-cho, Okayama City, Okayama, Japan.
Respir Investig. 2021 Mar;59(2):240-246. doi: 10.1016/j.resinv.2020.12.001. Epub 2021 Jan 9.
New therapeutic drugs have been developed for non-small cell lung cancer (NSCLC), and the prognosis of advanced NSCLC patients has improved. However, resistance to these drugs is a concern, and re-biopsy is necessary to determine the mechanism of drug resistance. There are many reports about the protocols for re-biopsy, including techniques such as bronchoscopy and computed tomography-guided needle biopsy (CTNB); however, there is no consensus on which method is optimal. Therefore, we retrospectively reviewed the bronchoscopy and CTNB re-biopsies conducted at our hospital.
We retrospectively analyzed 79 cases of re-biopsies with bronchoscopy or CTNB in patients with NSCLC from January 2014 to December 2016 at our institute.
Forty-nine cases of bronchoscopy and 30 cases of CTNB were taken for re-biopsy. The diagnostic rates of bronchoscopy and CTNB were 83.7% and 100%, respectively (p = 0.023). The complication rates of bronchoscopy and CTNB were 18.4% and 36.7%, respectively (p = 0.11), with a statistically significant difference in the incidence of pneumothorax (0% vs. 23.3%, respectively; p < 0.01). Pneumothorax required drainage in 6.7% of all CTNB cases. There were no fatalities in either group.
CTNB showed a higher diagnostic rate; however, it was associated with a higher rate of complications such as pneumothorax. Hence, the optimal modality must be determined individually for each patient.
新的治疗药物已被开发用于非小细胞肺癌（NSCLC），晚期 NSCLC 患者的预后得到了改善。然而，对这些药物的耐药性是一个关注点，需要重新进行活检以确定耐药机制。有许多关于重新活检方案的报告，包括支气管镜和计算机断层扫描引导下的针吸活检（CTNB）等技术；然而，哪种方法是最佳的还没有共识。因此，我们回顾性地审查了我们医院进行的支气管镜和 CTNB 重新活检。
我们回顾性分析了 2014 年 1 月至 2016 年 12 月期间我院 79 例 NSCLC 患者的支气管镜和 CTNB 重新活检。
49 例患者接受支气管镜活检，30 例患者接受 CTNB 活检。支气管镜和 CTNB 的诊断率分别为 83.7%和 100%（p=0.023）。支气管镜和 CTNB 的并发症发生率分别为 18.4%和 36.7%（p=0.11），气胸发生率差异有统计学意义（分别为 0%和 23.3%；p<0.01）。所有 CTNB 病例中有 6.7%需要引流气胸。两组均无死亡病例。
CTNB 显示出更高的诊断率；然而，它与气胸等并发症的发生率较高相关。因此，必须针对每个患者确定最佳方式。
