同步粗针活检与冷冻消融治疗高度可疑恶性肺结节的疗效与安全性

Efficacy and safety in synchronous core-needle biopsy and cryoablation for highly suspicious malignant pulmonary nodule.

作者信息

Zhang Tongyin, Xu Qiaoyu, Hu Yuwan, Li Haoyu, Du Haoran, Huang Zhenguo, Xie Sheng, Yang Meng, Xu Yanyan, Sun Hongliang

机构信息

Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China.

Graduate School, Chinese Academy of Medical Science &Peking Union Medical College, Beijing, 100730, China.

出版信息

Cancer Imaging. 2025 Jun 21;25(1):78. doi: 10.1186/s40644-025-00901-0.

DOI:10.1186/s40644-025-00901-0

PMID:40544289

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12182661/

Abstract

BACKGROUND

Percutaneous computed tomography (CT)-guided biopsy and cryoablation are commonly used techniques for diagnosing and treating pulmonary malignant tumors. Performing these procedures simultaneously allows for tissue diagnosis while potentially offering therapeutic benefits. This study aimed to evaluate whether the efficacy and safety of simultaneous percutaneous CT-guided biopsy and cryoablation in managing pulmonary tumors suspected of malignancy are comparable to those of sequential procedures.

METHODS

This retrospective study involved 124 patients with 131 highly suspicious malignant pulmonary nodules. Patients either underwent synchronous percutaneous core-needle biopsy and cryoablation (Group A) or separately underwent these procedures (Group B) from December 2020 to May 2024. All procedures were performed under CT guidance using a percutaneous approach. We analyzed technical success rates, complications, diagnostic yield, and local tumor control.

RESULTS

Technical success rates were 100% in both groups. The rate of pneumothorax was 42.1% (16/38) in Group A and 34.9% (30/86) in Group B. In Group A, hemoptysis and pleural effusion rates were 18.4% (7/38) and 23.7% (9/38), respectively, while in Group B, these rates were 16.3% (14/86) and 12.8% (11/86). These differences were not statistically significant. The diagnostic positive rate in Group A was 87.5%. The mean follow-up duration was 11.8 months (95% confidence interval [CI], 10.2-13.4), with local tumor control rates of 97% for Group A and 88% for Group B. The effectiveness rates of synchronous and separate procedures were similar.

CONCLUSION

Synchronous biopsy-ablation is an effective method for obtaining tumor pathology and local treatment of lung tumors simultaneously. It is a viable option for select patients where expedited diagnosis-therapy is clinically justified, particularly when molecular profiling is not immediately indicated.

摘要

背景

经皮计算机断层扫描（CT）引导下的活检和冷冻消融是诊断和治疗肺部恶性肿瘤的常用技术。同时进行这些操作可实现组织诊断，同时可能带来治疗益处。本研究旨在评估在疑似恶性的肺部肿瘤管理中，经皮CT引导下同步活检和冷冻消融的疗效和安全性是否与序贯操作相当。

方法

本回顾性研究纳入了124例患有131个高度可疑恶性肺结节的患者。2020年12月至2024年5月期间，患者要么接受同步经皮芯针活检和冷冻消融（A组），要么分别接受这些操作（B组）。所有操作均在CT引导下采用经皮方法进行。我们分析了技术成功率、并发症、诊断率和局部肿瘤控制情况。

结果

两组的技术成功率均为100%。A组气胸发生率为42.1%（16/38），B组为34.9%（30/86）。A组咯血和胸腔积液发生率分别为18.4%（7/38）和23.7%（9/38），而B组分别为16.3%（14/86）和12.8%（11/86）。这些差异无统计学意义。A组诊断阳性率为87.5%。平均随访时间为11.8个月（95%置信区间[CI]，10.2 - 13.4），A组局部肿瘤控制率为97%，B组为88%。同步和分别操作的有效率相似。