肺癌复发的增加 经过 transthoracic针活检 肺癌复发的增加
Seung Keun Yoon1, Mi Hyoung Moon1, Kyung Soo Kim1
1Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Journal of thoracic disease
|August 15, 2024
概括
在IA期非小细胞肺癌 (NSCLC) 患者的手术前计算机断层扫描引导的胸腔外针活检 (TNB) 与更高的复发风险有关. 考虑首先对早期肺癌进行手术诊断,以改善结果.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 诊断成像 诊断成像 诊断成像
背景情况:
- 计算机断层扫描 (CT) 引导的胸外针活检 (TNB) 可能会造成肺结构损伤和瘤细胞扩散的风险.
- 之前对TNB对患者预后的影响的研究已经产生了不清楚的结果.
- 这项研究专门研究了TNB对切除IA期非小细胞肺癌 (NSCLC) 复发风险的影响.
研究的目的:
- 为了确定手术前的TNB是否会增加切除阶段IANSCLC的患者复发的风险.
- 评估TNB在早期肺癌手术中的预后影响.
- 根据临床决策,就早期肺癌的术前诊断做出决定.
主要方法:
- 对1077名患有IA期NSCLC的患者进行了回顾性分析,这些患者接受了治疗切除 (2010-2020年).
- 考克斯回归分析以确定复发风险因素.
- 倾向性得分匹配和多变量考克斯分析,以评估TNB的独立效应.
主要成果:
- 手术前的TNB被确定为一个显著的负预后因素 (HR:3.15,P=0.003).
- 接受TNB治疗的患者的5年局部区域无复发存活率 (88.3%对96.8%) 和整体无复发存活率 (84.2%对93.7%) 显著降低.
- 倾向性得分匹配包括380名患者 (非TNB组) 在1:2匹配后与TNB组匹配.
结论:
- 手术前的TNB与IA阶段NSCLC复发的风险增加有关.
- 对于临床早期的肺癌,将手术诊断和治疗优先于术前组织诊断可能是有益的.
- 研究结果表明,应该重新考虑在切除前对IA期NSCLC的常规使用TNB.
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