Department of Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, 160# Pujian Road, Shanghai, 200127, China.
Department of Thoracic Surgery, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.
Cardiovasc Intervent Radiol. 2021 Aug;44(8):1204-1213. doi: 10.1007/s00270-021-02782-9. Epub 2021 Apr 6.
To evaluate the feasibility, safety, and diagnostic performance of sequential core-needle biopsy (CNB) technique following coaxial low-power microwave thermal coagulation (MTC) for ground-glass opacity (GGO) nodules.
From December 2017 to July 2019, a total of 32 GGOs (with diameter of 12 ± 4 mm) in 31 patients received two times of CNBs, both prior to and immediately after MTC at a power of 20 watts. The frequency and type of complications associated with CNBs were examined. The pathologic diagnosis and genetic analysis were performed for specimens obtained from the two types of biopsy.
The technical success rates of pre- and post-MTC CNBs were 94% and 100%, respectively. The complication rate was significantly lower with post-MTC CNB as compared to pre-MTC CNB (42% versus 97%, p < 0.001). Larger amount of specimens could be obtained by post-MTC CNB. The pathological diagnosis rate of post-MTC CNB was significantly higher than that of pre-MTC CNB (100% versus 75%, p = 0.008), whereas the success rates of genetic analysis were comparable between the two groups (100% versus 84%, p = 0.063). Regular ablation could be further performed after post-MTC CNB to achieve local tumor control.
Sequential biopsy following coaxial low-power MTC can reduce the risk of complications and provide high-quality specimens for pulmonary GGOs. Combining this technique with standard ablation allows for simultaneous diagnosis and treatment within a single procedure.
评估序贯核心针活检（CNB）技术在同轴低功率微波热凝固（MTC）治疗磨玻璃密度（GGO）结节后的可行性、安全性和诊断性能。
自 2017 年 12 月至 2019 年 7 月，31 例患者共 32 个 GGO（直径 12±4mm），在功率为 20 瓦时分别在 MTC 之前和之后两次接受 CNB。检查了与 CNB 相关的并发症的频率和类型。对两种活检获得的标本进行了病理诊断和基因分析。
MTC 前后 CNB 的技术成功率分别为 94%和 100%。与 MTC 前 CNB 相比，MTC 后 CNB 的并发症发生率显著降低（42%比 97%，p<0.001）。MTC 后 CNB 可获得更多的标本。MTC 后 CNB 的病理诊断率明显高于 MTC 前 CNB（100%比 75%，p=0.008），而两组的基因分析成功率相当（100%比 84%，p=0.063）。MTC 后 CNB 后可进一步进行常规消融以实现局部肿瘤控制。
同轴低功率 MTC 后序贯活检可降低并发症风险，并为肺部 GGO 提供高质量标本。将该技术与标准消融相结合，可在单次手术中同时进行诊断和治疗。
