Svaton Martin, Havel David, Buresova Marcela, Baxa Jan, Hosek Petr
Department of Pneumology and Phthisiology, Faculty of Medicine Pilsen, Charles University, University Hospital in Pilsen, Pilsen, Czech Republic.
Department of Imaging Methods, Faculty of Medicine Pilsen, Charles University, University Hospital in Pilsen, Pilsen, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2025 Mar;169(1):21-25. doi: 10.5507/bp.2024.030. Epub 2024 Sep 27.
Percutaneous transthoracic needle biopsy (PTNB), an alternative to bronchoscopic confirmation of lung lesions, is today being associated with a risk of pneumothorax and hemorrhage. Further, there are no data on the possible risk of malignant disease spreading to the pleura at the site of the PTNB. Previous studies have dealt with this risk in stage I non-small cell lung cancer only. The aim of this study was thus to assess the risk of pleural recurrence for all types of lung lesions. Secondary objectives included assessment of diagnostic yield and safety with respect to the incidence of pneumothorax and hemorrhage.
Clinical data of all patients from the University Hospital in Pilsen who had undergone PTNB of lung lesions between 1.1.2018 and 31.12.2022 were included in this retrospective study.
Following PTNB, ipsilateral pleural effusion occurred in 4.8% of patients without prior pleural infiltration. The effusion was confirmed as malignant in one patient (0.7%). Diagnostic yield of the method was 86.6%. We recorded pneumothorax or hemorrhage in the lung parenchyma or pleural space requiring medical intervention in 3.4% and 1.1% of patients, respectively.
In our study, percutaneous transthoracic needle biopsy of lung lesions showed high sensitivity and low degree of acute complications requiring an invasive solution. The risk of pleural recurrence after a biopsy was very low. Consequently, we continue to consider this method to be an alternative to bronchoscopy biopsies.
经皮经胸针吸活检术(PTNB)是支气管镜检查确诊肺部病变的一种替代方法,目前存在气胸和出血风险。此外,尚无关于PTNB部位恶性疾病可能扩散至胸膜的风险数据。既往研究仅涉及I期非小细胞肺癌的这一风险。因此,本研究的目的是评估所有类型肺部病变的胸膜复发风险。次要目标包括评估诊断率以及气胸和出血发生率方面的安全性。
本回顾性研究纳入了2018年1月1日至2022年12月31日期间在皮尔森大学医院接受肺部病变PTNB的所有患者的临床资料。
PTNB后,4.8%无既往胸膜浸润的患者出现同侧胸腔积液。其中1例患者(0.7%)的胸腔积液被确诊为恶性。该方法的诊断率为86.6%。我们记录到分别有3.4%和1.1%的患者在肺实质或胸膜腔出现需要医疗干预的气胸或出血。
在我们的研究中,肺部病变经皮经胸针吸活检术显示出高敏感性和低程度的需要侵入性解决方案的急性并发症。活检后胸膜复发的风险非常低。因此,我们继续认为该方法是支气管镜活检的一种替代方法。