[1]刘宝东.Ⅰ期非小细胞肺癌患者肺穿刺活检是否增加胸膜复发和气腔播散的风险[J].介入放射学杂志,2024,33(01):7-11.
　LIU Baodong..Dose pulmonary puncture biopsy increase the risk of pleural recurrence and air space spread of tumor in patients with stage Ⅰ non-small cell lung cancer？[J].journal interventional radiology,2024,33(01):7-11.
点击复制

Ⅰ期非小细胞肺癌患者肺穿刺活检是否增加胸膜复发和气腔播散的风险()

PDF下载中关闭

分享到：

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年01
页码:
7-11
栏目:
专论
出版日期:
2024-01-31

文章信息/Info

Title:
Dose pulmonary puncture biopsy increase the risk of pleural recurrence and air space spread of tumor in patients with stage Ⅰ non-small cell lung cancer？
作者:
刘宝东
Author(s):
LIU Baodong.
Department of Thoracic Surgery， Xuanwu Hospital， Capital Medical University， Beijing 100053， China
关键词:
【关键词】 肺癌;  肺结节;  肺活检;  胸膜复发;  肿瘤气腔播散
文献标志码:
A
摘要:
【摘要】 近年来，随着肺结节的比例升高，术前经皮肺穿刺活检或经支气管镜活检越来越受到重视。大量临床证据也证实，Ⅰ期非小细胞肺癌（non-small cell lung cancer，NSCLC）的肺穿刺活检是安全可行的。但是，由于肺磨玻璃结节的组织学特点，与实性结节相比穿刺时更容易发生出血或咳嗽，肿瘤细胞在血流或气流冲击下可能会沿着肺泡壁或针道种植，导致胸膜复发和气腔播散（spread through air spaces，STAS），尤其是胸膜下结节合并有脏层胸膜侵犯和淋巴细胞浸润时需要慎重选择。

参考文献/References:

［1］ Detterbeck FC， Mazzone PJ， Naidich DP， et al. Screening for lung cancer： diagnosis and management of lung cancer， 3rd ed： American College of Chest Physicians evidence-based clinical practice guidelines［J］. Chest， 2013， 143： e78S-e92S.
［2］ Yankelevitz DF， Yip R， Smith JP， et al. CT screening for lung cancer： nonsolid nodules in baseline and annual repeat rounds［J］. Radiology， 2015， 277： 555-564.
［3］ 徐国厚，黄海峡，陈 斌，等． 单体检中心23695例体检者首次胸部低剂量CT筛查结果及肺结节相关易感因素的研究［J］． 复旦学报（医学版）， 2020， 47：654-659， 668．
［4］ Baldwin DR， Callister ME，Guideline Development Group. The British Thoracic Society guidelines on the investigation and management of pulmonary nodules［J］. Thorax， 2015， 70： 794-798.
［5］ MacMahon H， Naidich DP， Goo JM， et al. Guidelines for management of incidental pulmonary nodules detected on CT images： from the fleischner society 2017［J］. Radiology， 2017， 284： 228-243.
［6］ 周清华，范亚光，王 颖，等． 中国肺部结节分类、诊断与治疗指南（2016年版）［J］． 中国肺癌杂志， 2016， 19：793-798．
［7］ Travis WD， Brambilla E， Nicholson AG， et al. The 2015 World Health Organization classification of lung tumors： impact of genetic， clinical and radiologic advances since the 2004 classification［J］. J Thorac Oncol， 2015， 10： 1243-1260.
［8］ Nakajima J， Sato H， Takamoto S. Does preoperative transbronchial biopsy worsen the postsurgical prognosis of lung cancer? A propensity score-adjusted analysis［J］. Chest， 2005， 128： 3512-3518.
［9］ 何 闯，吴 蔚，袁 晶，等． CT引导下穿刺活检对ⅠA期非小细胞肺癌疾病无进展生存期和总生存期的影响［J］． 介入放射学杂志， 2020， 29：372-375．
［10］ Yang JS， Liu YM， Mao YM， et al. Meta-analysis of CT-guided transthoracic needle biopsy for the evaluation of the ground-glass opacity pulmonary lesions［J］. Br J Radiol， 2014， 87： 20140276.
［11］ Kim J， Chee CG， Cho J， et al. Diagnostic accuracy and complication rate of image-guided percutaneous transthoracic needle lung biopsy for subsolid pulmonary nodules： a systematic review and meta-analysis［J］. Br J Radiol， 2021， 94： 20210065.
［12］ Lee KH， Lim KY， Suh YJ， et al. Nondiagnostic percutaneous transthoracic needle biopsy of lung lesions： a multicenter study of malignancy risk［J］. Radiology， 2019， 290： 814-823.
［13］ Lee KH， Lim KY， Suh YJ， et al. Diagnostic accuracy of percutaneous transthoracic needle lung biopsies： a multicenter study［J］. Korean J Radiol， 2019， 20： 1300-1310.
［14］ Suh YJ， Lee JH， Hur J， et al. Predictors of false-negative results from percutaneous transthoracic fine-needle aspiration biopsy： an observational study from a retrospective cohort［J］. Yonsei Med J， 2016， 57： 1243-1251.
［15］ Choi SH， Chae EJ， Kim JE， et al. Percutaneous CT-guided aspiration and core biopsy of pulmonary nodules smaller than 1 cm： analysis of outcomes of 305 procedures from a tertiary referral center［J］. AJR Am J Roentgenol， 2013， 201： 964-970.
［16］ Lu CH， Hsiao CH， Chang YC， et al. Percutaneous computed tomography-guided coaxial core biopsy for small pulmonary lesions with ground-glass attenuation［J］. J Thorac Oncol， 2012， 7： 143-150.
［17］ Wu CC， Maher MM， Shepard JA. Complications of CT-guided percutaneous needle biopsy of the chest： prevention and management［J］. AJR Am J Roentgenol， 2011， 196： W678-W682.
［18］ Tomiyama N， Yasuhara Y， Nakajima YS， et al. CT-guided needle biopsy of lung lesions： a survey of severe complication based on 9783 biopsies in Japan［J］. Eur J Radiol， 2006， 59： 60-64.
［19］ Wiener RS， Schwartz LM， Woloshin S， et al. Population-based risk for complications after transthoracic needle lung biopsy of a pulmonary nodule： an analysis of discharge records［J］. Ann Intern Med， 2011， 155： 137-144.
［20］ Yoon SH， Park CM， Lee KH， et al. Analysis of complications of percutaneous transthoracic needle biopsy using CT-guidance modalities in a multicenter cohort of 10568 biopsies［J］. Korean J Radiol， 2019， 20： 323-331.
［21］ Huang MD， Weng HH， Hsu SL， et al. Accuracy and complications of CT-guided pulmonary core biopsy in small nodules： a single-center experience［J］. Cancer Imaging， 2019， 19： 51.
［22］ Gex G， Pralong JA， Combescure C， et al. Diagnostic yield and safety of electromagnetic navigation bronchoscopy for lung nodules： a systematic review and meta-analysis［J］. Respiration， 2014， 87： 165-176.
［23］ Folch EE， Pritchett MA， Nead MA， et al. Electromagnetic navigation bronchoscopy for peripheral pulmonary lesions： one-year results of the prospective， multicenter NAVIGATE study［J］. J Thorac Oncol， 2019， 14： 445-458.
［24］ Sawabata N， Ohta M， Maeda H. Fine-needle aspiration cytologic technique for lung cancer has a high potential of malignant cell spread through the tract［J］. Chest， 2000， 118： 936-939.
［25］ Moon SM， Lee DG， Hwang NY， et al. Ipsilateral pleural recurrence after diagnostic transthoracic needle biopsy in pathological stage Ⅰ lung cancer patients who underwent curative resection［J］. Lung Cancer， 2017， 111： 69-74.
［26］ Ahn SY， Yoon SH， Yang BR， et al. Risk of pleural recurrence after percutaneous transthoracic needle biopsy in stage Ⅰ non-small-cell lung cancer［J］. Eur Radiol， 2019， 29： 270-278.
［27］ Kim MG， Yang BR， Park CM， et al. Preoperative percutaneous needle lung biopsy techniques and ipsilateral pleural recurrence in stage Ⅰ lung cancer［J］. Eur Radiol， 2022， 32： 2683-2692.
［28］ Hong H， Hahn S， Matsuguma H， et al. Pleural recurrence after transthoracic needle lung biopsy in stage Ⅰ lung cancer： a systematic review and individual patient-level meta-analysis［J］. Thorax， 2021， 76： 582-590.
［29］ Hao M， Fang Z， Ding J， et al. Effects of preoperative needle biopsy for lung cancer on survival and recurrence： a systematic review and meta-analysis［J］. Surg Today， 2022， Epub ahead of print.
［30］ Wang T， Luo L， Zhou Q. Risk of pleural recurrence in early stage lung cancer patients after percutaneous transthoracic needle biopsy： a meta-analysis［J］. Sci Rep， 2017， 7： 42762.
［31］ Li H， Chen R， Zhao J. Correlation between percutaneous transthoracic needle biopsy and recurrence in stage Ⅰ lung cancer： a systematic review and meta-analysis［J］. BMC Pulm Med， 2020， 20： 198.
［32］ Cheng D， Wang Z， Cui J， et al. Does percutaneous transthoracic needle biopsy increase the risk of pleural recurrence in patients with stage Ⅰ lung cancer?［J］. Interact Cardiovasc Thorac Surg， 2020， 30： 834-838.
［33］ Kodama T， Kameya T， Shimosato Y， et al. Cell incohesiveness and pattern of extension in a rare case of bronchioloalveolar carcinoma［J］. Ultrastruct Pathol， 1980， 1： 177-188.
［34］ Onozato ML， Kovach AE， Yeap BY， et al. Tumor islands in resected early-stage lung adenocarcinomas are associated with unique clinicopathologic and molecular characteristics and worse prognosis［J］. Am J Surg Pathol， 2013， 37： 287-294.
［35］ Kadota K， Nitadori JI， Sima CS， et al. Tumor spread through air spaces is an important pattern of invasion and impacts the frequency and location of recurrences after limited resection for small stage Ⅰ lung adenocarcinomas［J］. J Thorac Oncol， 2015， 10： 806-814.
［36］ Uruga H， Fujii T， Fujimori S， et al. Semiquantitative assessment of tumor spread through air spaces（STAS） in early-stage lung adenocarcinomas［J］. J Thorac Oncol， 2017， 12： 1046-1051.
［37］ Toyokawa G， Yamada Y， Tagawa T， et al. Significance of spread through air spaces in resected pathological stage Ⅰ lung adenocarcinoma［J］. Ann Thorac Surg， 2018， 105： 1655-1663.
［38］ Dai C， Xie H， Su H， et al. Tumor spread through air spaces affects the recurrence and overall survival in patients with lung adenocarcinoma＞2 to 3 cm［J］. J Thorac Oncol， 2017， 12： 1052-1060.
［39］ Warth A， Muley T， Kossakowski C， et al. Prognostic impact of intra-alveolar tumor spread in pulmonary adenocarcinoma［J］. Am J Surg Pathol， 2015， 39： 793-801.
［40］ Han YB， Kim H， Mino-Kenudson M， et al. Tumor spread through air spaces（STAS）： prognostic significance of grading in non-small cell lung cancer［J］. Mod Pathol， 2021， 34： 549-561.
［41］ Chen S， Ye T， Yang S， et al. Prognostic implication of tumor spread through air spaces in patients with pathologic N0 lung adenocarcinoma［J］. Lung Cancer， 2022， 164： 33-38.
［42］ Kim SK， Kim TJ， Chung MJ， et al. Lung adenocarcinoma： CT features associated with spread through air spaces［J］. Radiology， 2018， 289： 831-840.
［43］ Yanagawa N， Shiono S， Endo M， et al. Tumor spread through air spaces is a useful predictor of recurrence and prognosis in stage I lung squamous cell carcinoma， but not in stage Ⅱ and Ⅲ［J］. Lung Cancer， 2018， 120： 14-21.
［44］ Eguchi T， Kameda K， Lu S， et al. Lobectomy is associated with better outcomes than sublobar resection in spread through air spaces（STAS）-positive T1 lung adenocarcinoma： a propensity score-matched analysis［J］. J Thorac Oncol， 2019， 14： 87-98.
［45］ Yin Q， Wang H， Cui H， et al. Meta-analysis of association between CT-based features and tumor spread through air spaces in lung adenocarcinoma［J］. J Cardiothorac Surg， 2020， 15： 243.
［46］ Zhong Y， Xu Y， Deng J， et al. Prognostic impact of tumour spread through air space in radiological subsolid and pure solid lung adenocarcinoma［J］. Eur J Cardiothorac Surg， 2021， 59： 624-632.
［47］ Watanabe Y， Hattori A， Nojiri S， et al. Clinical impact of a small component of ground-glass opacity in solid-dominant clinical stage ⅠA non-small cell lung cancer［J］. J Thorac Cardiovasc Surg， 2022， 163： 791-801.e4.
［48］ Wang S， Hao J， Qian C， et al. Tumor spread through air spaces is a survival predictor in non-small-cell lung cancer［J］. Clin Lung Cancer， 2019， 20： e584-e591.
［49］ Chen D， Mao Y， Wen J， et al. Tumor spread through air spaces in non-small cell lung cancer： a systematic review and meta-analysis［J］. Ann Thorac Surg， 2019， 108： 945-954.
［50］ Liu H， Yin Q， Yang G， et al. Prognostic impact of tumor spread through air spaces in non-small cell lung cancers： a meta-analysis including 3564 patients［J］. Pathol Oncol Res， 2019， 25： 1303-1310.
［51］ Kameda K， Eguchi T， Lu S， et al. Preoperative needle biopsy and tumor spread through alveolar spaces（STAS） in resected lung adenocarcinomas［J］. J Thorac Oncol， 2017， 12： S1458.
［52］ Lee GY， Chung JH， Cho S， et al. Impact of preoperative diagnostic biopsy procedure on spread through airspaces and related outcomes in resected stage Ⅰ non-small cell lung cancer［J］. Chest， 2022， 162： 1199-1212.
［53］ Hu CP， Jiang J， Li Y， et al. Recurrence risk after preoperative biopsy in patients with resected early-stage non-small-cell lung cancer： a retrospective study［J］. Cancer Manag Res， 2018， 10： 1927-1934.
［54］ Ding Y， Li J， Li X， et al. Impact of preoperative biopsy on tumor spread through air spaces in stage I non-small cell lung cancer： a propensity score-matched study［J］. BMC Pulm Med， 2022， 22： 293.

相似文献/References:

[1]贺克武,高 斌,秦汉林,等. 125I粒子组织间植入联合支气管动脉灌注化疗治疗肺癌的疗效观察[J].介入放射学杂志,2012,(07):554.
　HE Ke- wu,GAO Bin,QIN Han- lin,et al.CT?蛳 guided percutaneous 125I seed implantation combined with bronchial arterial infusion chemotherapy for lung cancers： observation of therapeutic efficacy[J].journal interventional radiology,2012,(01):554.
[2]罗 君,邵国良,郑家平,等.CT引导下射频消融治疗33例肺癌的回顾性分析[J].介入放射学杂志,2015,(06):530.
　LUO Jun,SHAO Guo-liang,ZHENG Jia-ping,et al.CT-guided radiofrequency ablation for lung cancer： a retrospective analysis of 35 cases[J].journal interventional radiology,2015,(01):530.
[3]王力伟,张丽云,王忠敏.移植性肺癌动物模型研究进展[J].介入放射学杂志,2015,(07):645.
　WANG Li- wei,ZHANG Li- yun,WANG Zhong- min.Transplanted pulmonary cancer model in experimental animals： recent progress in research[J].journal interventional radiology,2015,(01):645.
[4]牛丹丹,万娅敏,周志刚,等.CT灌注联合能谱成像评价射频消融治疗肺癌近期疗效[J].介入放射学杂志,2016,(04):325.
　NIU Dan- dan,WAN Ya- min,ZHOU Zhi- gang,et al.Application of CT perfusion scanning combined with spectral imaging in evaluating the short- term effect of radiofrequency ablation for pulmonary adenocarcinomas[J].journal interventional radiology,2016,(01):325.
[5]黄大钡,李晓群,张 健,等.C臂CT在肺小结节胸腔镜切除术前定位中的应用[J].介入放射学杂志,2017,(09):843.
　HUANG Dabei,LI Xiaoqun,ZHANG Jian,et al.The application of C- arm CT in guiding preoperative hook- wire localization of solitary pulmonary nodule before thoracoscopic resection[J].journal interventional radiology,2017,(01):843.
[6]王东东,李晓光,李 彬,等.经同轴套管穿刺活检同步微波消融治疗高度可疑恶性肺结节 [J].介入放射学杂志,2018,27(11):1040.
　WANG Dongdong,LI Xiaoguang,LI Bin,et al.Simultaneous core needle biopsy and microwave ablation via coaxial cannula for highly suspected malignant pulmonary nodules[J].journal interventional radiology,2018,27(01):1040.
[7]杜 随,梁岩松,牛书雷,等.125I粒子植入治疗肺癌并发症的临床观察 [J].介入放射学杂志,2018,27(11):1060.
　DU Sui,LIANG Yansong,NIU Shulei,et al.Clinical observation of the complications caused by 125I seed implantation brachytherapy for lung cancers[J].journal interventional radiology,2018,27(01):1060.
[8]徐家华,顾小强,李 鑫,等.靶向刀治疗Ⅰ期肺癌临床应用[J].介入放射学杂志,2019,28(10):958.
　XU Jiahua,GU Xiaoqiang,LI Xing,et al.Clinical application of targeted knife in treating stage Ⅰ lung cancers[J].journal interventional radiology,2019,28(01):958.
[9]王晴文,李言琦,张 琛,等.1.0T磁共振引导下肺结节微波消融围手术期护理[J].介入放射学杂志,2019,28(11):1110.
　WANG Qingwen,LI Yanqi,ZHANG Chen,et al.1.0T open MRI-guided microwave ablation for pulmonary nodules： experience of perioperative nursing care[J].journal interventional radiology,2019,28(01):1110.
[10]郭跃辉,朱庆云,陈石伟,等.肺癌小肠转移致急性肠梗阻治疗1例[J].介入放射学杂志,2021,30(03):319.
　GUO Yuehui,ZHU Qingyun,CHEN Shiwei,et al.Acute small bowel obstruction caused by small intestinal metastasis from lung cancer： report of one case[J].journal interventional radiology,2021,30(01):319.

备注/Memo

备注/Memo:
（收稿日期：2022-11-25）
（本文编辑：茹 实）
更新日期/Last Update: 2024-01-30