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经支气管冷冻活检术对老年肺癌患者的安全性及有效性

Safety and efficacy of transbronchial cryobiopsy for elderly lung cancer patients.

作者信息

Yamatsuta Kumiko, Okachi Shotaro, Hasegawa Shin, Ota Maki, Kako Hisashi, Ina Takuma, Horiguchi Tomoya, Oya Yuko, Goto Yasuhiro, Hashimoto Naozumi, Imaizumi Kazuyoshi

机构信息

Department of Respiratory Medicine, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Aichi, Japan.

出版信息

BMC Pulm Med. 2024 Dec 26;24(1):632. doi: 10.1186/s12890-024-03456-1.

Abstract

BACKGROUND

The increasing prevalence of lung cancer in the elderly population necessitates a closer evaluation of diagnostic and therapeutic approaches. This study aimed to compare the safety and diagnostic efficacy of transbronchial lung cryobiopsy (TBLC) between patients ≥ 80 years and younger patients.

METHODS

A retrospective review was conducted of 96 patients diagnosed with peripheral lung cancer who underwent TBLC between April 2021 and October 2023. The patients were categorized into two groups: the elderly group (age ≥ 80 years, n = 20) and younger group (age < 80 years; n = 76). Data regarding the biopsy yield, complications, and feasibility of molecular analyses were collected and analyzed.

RESULTS

The diagnostic yield of TBLC was comparable between the elderly and younger groups (95% vs. 89.5%, p = 0.679). Biomarker testing, including programmed death-ligand 1 expression and genetic mutations, were feasible in all cases diagnosed with cancer using TBLC samples. No significant differences were observed in major complications such as pneumothorax or bleeding.

CONCLUSIONS

TBLC was found to be a safe and effective diagnostic tool for peripheral lung cancer in elderly patients and provided adequate samples for molecular testing. Since the complication rates did not significantly differ between the two age groups, age alone should not be considered a contraindication for the procedure.

摘要

背景

老年人群中肺癌患病率不断上升,因此有必要更深入地评估诊断和治疗方法。本研究旨在比较80岁及以上患者与年轻患者经支气管肺冷冻活检(TBLC)的安全性和诊断效能。

方法

对2021年4月至2023年10月期间接受TBLC诊断为周围型肺癌的96例患者进行回顾性研究。患者分为两组:老年组(年龄≥80岁,n = 20)和年轻组(年龄<80岁;n = 76)。收集并分析有关活检取材成功率、并发症以及分子分析可行性的数据。

结果

TBLC的诊断取材成功率在老年组和年轻组之间相当(95%对89.5%,p = 0.679)。使用TBLC样本诊断为癌症的所有病例中,包括程序性死亡配体1表达和基因突变在内的生物标志物检测均可行。气胸或出血等主要并发症未观察到显著差异。

结论

TBLC被发现是老年患者周围型肺癌的一种安全有效的诊断工具,并为分子检测提供了足够的样本。由于两个年龄组的并发症发生率没有显著差异,不应仅将年龄视为该操作的禁忌证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b805/11670518/6c405bc7c9e8/12890_2024_3456_Fig1_HTML.jpg

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