Department of Gastroenterology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Japan.
Translational Research and Development Center, Chiba University Hospital, Chiba, Japan.
Int J Clin Oncol. 2022 Sep;27(9):1459-1466. doi: 10.1007/s10147-022-02195-9. Epub 2022 Jun 15.
With the evolution of personalized medicine in the field of oncology, which includes optimal treatment selection using next-generation sequencing-based companion diagnostic systems and tumor-agnostic treatments according to common biomarkers, a liver tumor biopsy technique that can obtain a sufficient specimen volume must be established. The current study aimed to evaluate the safety and availability of a liver tumor biopsy technique with multiple puncture sites made using a coaxial introducer needle and embolization with gelatin sponge particles.
Patients with primary or metastatic liver cancer who underwent liver tumor biopsies with puncture tract embolization using gelatin sponge (Spongel) from October 2019 to September 2020 were included in the study. The complication and diagnostic rates were evaluated, and whether the specimen volume was sufficient for Foundation CDx was investigated.
In total, 96 patients were enrolled in this analysis. The median total number of puncture times per patient was 3 (range 1-8). The pathological diagnostic rate was 79.2%. Using the FoundationOne CDx, specimens with a sufficient volume required for genomic medicine were collected in 84.9% of patients. The incidence rate of bleeding was 4.2% (n = 4), and only one patient presented with major bleeding requiring transfusion.
Liver biopsy with puncture tract embolization using a gelatin sponge may be safe and effective for collecting specimens with a volume sufficient for modern cancer treatments.
随着肿瘤学领域个性化医学的发展,包括使用基于下一代测序的伴随诊断系统进行最佳治疗选择,以及根据常见生物标志物进行肿瘤不可知的治疗,必须建立一种能够获得足够标本量的肝肿瘤活检技术。本研究旨在评估使用同轴导入器针进行多点穿刺和明胶海绵颗粒栓塞的肝肿瘤活检技术的安全性和可行性。
本研究纳入了 2019 年 10 月至 2020 年 9 月期间接受过经皮肝穿刺活检术联合明胶海绵(Spongel)栓塞的原发性或转移性肝癌患者。评估了并发症和诊断率,并研究了标本量是否足以进行 Foundation CDx。
共有 96 例患者纳入本分析。每位患者的平均穿刺次数为 3 次(范围 1-8 次)。病理诊断率为 79.2%。使用 FoundationOne CDx,84.9%的患者采集到了足够进行基因组医学检测的标本量。出血发生率为 4.2%(n=4),仅有 1 例患者出现需要输血的大出血。
使用明胶海绵进行经皮肝穿刺活检术联合穿刺道栓塞可能是一种安全有效的方法,可以获得足够用于现代癌症治疗的标本量。