The association between core number and complications in ultrasound-guided percutaneous lung core needle biopsy for subpleural primary lung cancer: a retrospective study.

Abstract

Background: With advances in lung cancer management, there is a growing need for larger tissue samples to enable tumor genomic analysis and characterization.This study aims to determine whether the core number obtained during Ultrasound-guided percutaneous lung core needle biopsy(US-PLCNB) is associated with post-procedural complications.

Methods: This retrospective study enrolled consecutive patients who underwent US-PLCNB for subpleural primary lung cancer at Shanghai Pulmonary Hospital between July 2019 and September 2021. Patient data were extracted from medical records, including demographics, lesion size, and core number. Post-procedural complications, including hemoptysis, pneumothorax, intolerable pain, pleural reaction, hemothorax, and delayed hemopneumothorax, were documented. Multivariate logistic regression models were used to evaluate whether the core number was an independent predictor of complications following US-PLCNB.

Results: A total of 1,151 patients (mean age, 64.47 ± 10.58 [SD] years; 278 [24.15%] females and 873 [75.85%] males) were included. The median lesion size was 58 mm (IQR, 41-77 mm). Among the 1,151 patients, 417 (36.23%) were diagnosed with lung adenocarcinoma, and 322 (27.98%) with lung squamous cell carcinoma. Post-procedural complications occurred in 41 patients (3.56%), including: hemoptysis (26 cases, 2.26%), pneumothorax (7 cases, 0.61%), intolerable pain (3 cases, 0.26%), vasovagal reaction (2 cases, 0.17%), hemothorax (2 cases, 0.17%), and delayed hemopneumothorax (1 case, 0.09%). The median number of biopsy cores obtained was 3 (range: 1-7). Multivariate analysis revealed no evidence of an association between the number of cores and complications: hemoptysis (OR = 0.820, P = 0.410), pneumothorax (OR = 1.220, P = 0.663), intolerable pain (OR = 0.520, P = 0.387), vasovagal reaction (OR = 1.087, P = 0.924), hemothorax (OR = 1.062, P = 0.944), delayed hemopneumothorax (OR = 1.118, P = 0.930).

Conclusion: In patients undergoing US-PLCNB for primary lung cancer, no evidence was found of an association between the core number biopsy samples obtained and post-procedural complications.