18F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）检查结果与经支气管肺活检及支气管内超声引导下经支气管针吸活检中用于基因检测的足够组织样本的相关性
Association of FDG-PET/CT findings with adequate tissue samples for gene panel testing in transbronchial lung biopsy and endobronchial ultrasound-guided transbronchial needle aspiration.
作者信息
Tamura Akiko, Ko Ryo, Kenmotsu Hirotsugu, Kawata Takuya, Matsuda Suguru, Morita Meiko, Sekikawa Motoki, Doshita Kosei, Yabe Michitoshi, Kodama Hiroaki, Miura Keita, Iida Yuko, Mamesaya Nobuaki, Kobayashi Haruki, Wakuda Kazushige, Ono Akira, Naito Tateaki, Murakami Haruyasu, Nokihara Hiroshi, Hojo Masayuki, Takahashi Toshiaki
机构信息
Shizuoka Cancer Center, Shimonagakubo 1007, Nagaizumi-cho Sunto-gun, Shizuoka, 411-8777, Japan; National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku, Tokyo, 162-8655, Japan.
Shizuoka Cancer Center, Shimonagakubo 1007, Nagaizumi-cho Sunto-gun, Shizuoka, 411-8777, Japan.
出版信息
Respir Investig. 2025 Sep;63(5):898-903. doi: 10.1016/j.resinv.2025.07.004. Epub 2025 Jul 18.
BACKGROUND
Gene panel testing is recommended for determining treatment strategies in advanced non-small cell lung cancer (NSCLC), and ensuring adequate biopsy sample volume is crucial for successful testing. However, the factors contributing to sample insufficiency remain unclear. While fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) can detect viable tumor cells, previous studies found no significant correlation between maximum standardized uptake values (SUVmax) and successful gene panel testing. Here, PET-necrosis, a PET/CT parameter indicating necrotic tissue, was investigated as a potential predictor of acquiring insufficient tissue samples in bronchoscopy biopsies.
METHODS
We retrospectively reviewed patients with advanced NSCLC who underwent transbronchial lung biopsy (TBB) or endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for gene panel testing at Shizuoka Cancer Center from 2022 to 2024. Data on PET-necrosis, SUVmax, and other clinical variables were collected, with panel-biopsy failure defined as cases requiring re-biopsy, single-plex testing, or cell pellet-based gene panel testing due to inadequate/negative samples. Logistic regression analysis was used to assess the association between the PET/CT parameters and panel-biopsy failure.
RESULTS
Of the 239 patients assessed, 176 underwent TBB, and 63 underwent EBUS-TBNA. Panel-biopsy failure occurred in 18.8 % of TBB and 23.8 % of EBUS-TBNA. In logistic regression analysis, PET-necrosis was associated with higher risk of panel-biopsy failure for both TBB (OR 3.16, p = 0.033) and EBUS-TBNA (OR 7.89, p = 0.03), while SUVmax showed no correlation.
CONCLUSIONS
PET-necrosis was associated with panel-biopsy failure in both TBB and EBUS-TBNA. PET/CT findings might better be considered when selecting biopsy sites for gene panel testing.
背景
基因检测 panel 推荐用于确定晚期非小细胞肺癌（NSCLC）的治疗策略，确保足够的活检样本量对检测成功至关重要。然而，导致样本不足的因素仍不清楚。虽然氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）可以检测存活的肿瘤细胞，但先前的研究发现最大标准化摄取值（SUVmax）与成功的基因检测 panel 之间无显著相关性。在此，PET-坏死（一种指示坏死组织的PET/CT参数）被研究作为支气管镜活检中获取不足组织样本的潜在预测指标。
方法
我们回顾性分析了2022年至2024年在静冈癌症中心接受经支气管肺活检（TBB）或支气管内超声引导下经支气管针吸活检（EBUS-TBNA）进行基因检测 panel 的晚期NSCLC患者。收集了PET-坏死、SUVmax和其他临床变量的数据，panel活检失败定义为由于样本不足/阴性而需要重新活检、单重检测或基于细胞沉淀的基因检测 panel 的病例。采用逻辑回归分析评估PET/CT参数与panel活检失败之间的关联。
结果
在评估的239例患者中，176例接受了TBB，63例接受了EBUS-TBNA。TBB中有18.8%发生了panel活检失败，EBUS-TBNA中有23.8%发生了panel活检失败。在逻辑回归分析中，PET-坏死与TBB（OR 3.16，p = 0.033）和EBUS-TBNA（OR 7.89，p = 0.03）的panel活检失败风险较高相关，而SUVmax无相关性。
结论
PET-坏死与TBB和EBUS-TBNA中的panel活检失败相关。在为基因检测 panel 选择活检部位时，可能更好地考虑PET/CT结果。
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