经皮 CT 引导下的核心针活检可用于组织学证实肺神经内分泌肿瘤的临床特征和长期预后。

Percutaneous computed tomography-guided core needle biopsy can be used to histologically confirm the clinical features and long-term prognosis of pulmonary neuroendocrine neoplasms.

机构信息

Department of Interventional Radiology, Fudan University Shanghai Cancer Center, No.270 Dongan Road, Xuhui, 200032, Shanghai, China.

出版信息

Jpn J Radiol. 2023 Dec;41(12):1414-1419. doi: 10.1007/s11604-023-01465-4. Epub 2023 Jul 3.

DOI:10.1007/s11604-023-01465-4

PMID:37395983

Abstract

PURPOSE

We investigated the clinical features and prognosis outcomes of pulmonary neuroendocrine neoplasms (PNENs) which were histologically confirmed after percutaneous computed tomography-guided core needle biopsy (PCT-CNB).

MATERIALS AND METHODS

We retrospectively investigated 173 patients who had PNENs which were histologically confirmed after PCT-CNB; patients were split into low and intermediate-grade neuroendocrine tumor (LIGNET) (typical carcinoid (TC) and atypical carcinoid (AC)) and high-grade neuroendocrine carcinoma-tumor (HGNEC) groups. In this latter group, patients were further subdivided into large-cell neuroendocrine carcinoma (LCNEC), small-cell lung cancer (SCLC), and high-grade neuroendocrine carcinoma-not otherwise specified (HGNEC-NOS) groups. Complications after biopsy were recorded. We also assessed overall survival (OS) rates using Kaplan-Meier curves, with prognostic factors determined using univariate and multivariate analyses.

RESULTS

Complications were mainly pneumothorax (22.5; 39/173 patients), chest tube placement (4.0; 7/173 patients), and pulmonary bleeding (33.5%; 58/173 procedures)-no patient mortality was recorded. Definitive diagnoses were ascribed to 102 SCLC, 10 LCNEC, 43 HGNEC-NOS, 7 TC, and 11 AC patients. The 1- and 3-year OS rates in the LIGNET group were 87.5% and 68.1%, respectively, and 59.2 and 20.9% in the HGNEC group, respectively these data were statistically significant (P = 0.010). For SCLC, 1- and 3-year OS rates were 63.3 and 22.3%, 30.0 and 10.0% for LCNEC, and 53.3% and 20.1% for HGNEC-NOS, respectively (P = 0.031). Independent prognostic factors for OS included disease type and distant metastasis.

CONCLUSION

PNENs may be pathologically diagnosed using PCT-CNB. While differential diagnoses between LCNEC and SCLC are problematic in some patients, a HGNEC-NOS diagnosis was ascribed and PCT-CNB samples were shown to predict NEN OS rates.

摘要

目的

我们研究了经皮 CT 引导下穿刺活检（PCT-CNB）后组织学证实的肺神经内分泌肿瘤（PNENs）的临床特征和预后结局。

材料和方法

我们回顾性研究了 173 例经 PCT-CNB 组织学证实为 PNENs 的患者；将患者分为低级别和中级别神经内分泌肿瘤（LIGNET）（典型类癌（TC）和非典型类癌（AC））和高级别神经内分泌癌-肿瘤（HGNEC）组。在后一组中，患者进一步分为大细胞神经内分泌癌（LCNEC）、小细胞肺癌（SCLC）和高级别神经内分泌癌-未另作说明（HGNEC-NOS）组。记录活检后的并发症。我们还使用 Kaplan-Meier 曲线评估总生存率（OS），使用单因素和多因素分析确定预后因素。

结果

并发症主要为气胸（22.5%；39/173 例患者）、胸腔引流管放置（4.0%；7/173 例患者）和肺出血（33.5%；58/173 例）-无患者死亡。102 例 SCLC、10 例 LCNEC、43 例 HGNEC-NOS、7 例 TC 和 11 例 AC 患者被明确诊断。LIGNET 组的 1 年和 3 年 OS 率分别为 87.5%和 68.1%，HGNEC 组分别为 59.2%和 20.9%，数据具有统计学意义（P=0.010）。SCLC 的 1 年和 3 年 OS 率分别为 63.3%和 22.3%、30.0%和 10.0%，LCNEC 为 53.3%和 20.1%，HGNEC-NOS 为 53.3%和 20.1%，差异具有统计学意义（P=0.031）。OS 的独立预后因素包括疾病类型和远处转移。