{"title":"ct引导下肺部病变经皮经胸穿刺活检中不必要重复活检的多中心研究。","authors":"Yangfan He, Huanhuan He, Yubo Cai, Shanshan Lyu, Zhengyi Zhou, Chengyou Zheng, Xinke Zhang, Jinling Duan, Jierong Chen, Jiewei Chen","doi":"10.1002/cam4.71228","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Objective</h3>\n \n <p>Computed tomography-guided percutaneous transthoracic needle biopsy of pulmonary lesions (PTNBP) is widely used for diagnosing and managing lung cancer. However, rebiopsies are often required due to insufficient specimens for definitive pathological diagnosis and molecular testing, which increase patient burden and reduce treatment efficiency. This study aims to investigate the characteristics of rebiopsies and propose strategies to minimize unnecessary rebiopsies.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 12,882 PTNBP cases from three centers were analyzed from January 2018 to December 2022. Attribution analysis was conducted for the rebiopsy cases, and descriptive analysis was conducted for clinical parameters.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The rebiopsy rate was 6.5% (841/12,882), with 31.0% (261/841) of rebiopsies due to insufficient specimens. Among these cases, 87.0% (227/261) were stage III–IV, 89.7% (234/261) had poorly differentiated tumors, and 80.1% (209/261) were non-small cell lung cancer (NSCLC). The proportion of molecular testing in stage IV cases was significantly higher than in stage I–III cases (44.8% vs. 25.3%, <i>p</i> = 0.0022). Poorly differentiated cases required significantly more biomarkers in immunohistochemistry and special staining than moderately and well-differentiated cases (8.1 vs. 4.0, <i>p</i> = 0.0039). Insufficient tissue rates were significantly higher in cases with only one biopsy core compared to those with more cores (2.4% vs. 1.5%, <i>p</i> = 0.0088).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Patients with advanced-stage disease, poorly differentiated tumors, and NSCLC undergoing PTNBP are more likely to require rebiopsy due to insufficient specimens. Increasing the number of biopsy cores (≥ 2) and implementing one-stop management for pathological assessment may effectively reduce unnecessary rebiopsies in PTNBP.</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477545/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Multicenter Study on Unnecessary Rebiopsies in CT-Guided Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions\",\"authors\":\"Yangfan He, Huanhuan He, Yubo Cai, Shanshan Lyu, Zhengyi Zhou, Chengyou Zheng, Xinke Zhang, Jinling Duan, Jierong Chen, Jiewei Chen\",\"doi\":\"10.1002/cam4.71228\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background and Objective</h3>\\n \\n <p>Computed tomography-guided percutaneous transthoracic needle biopsy of pulmonary lesions (PTNBP) is widely used for diagnosing and managing lung cancer. However, rebiopsies are often required due to insufficient specimens for definitive pathological diagnosis and molecular testing, which increase patient burden and reduce treatment efficiency. This study aims to investigate the characteristics of rebiopsies and propose strategies to minimize unnecessary rebiopsies.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A total of 12,882 PTNBP cases from three centers were analyzed from January 2018 to December 2022. Attribution analysis was conducted for the rebiopsy cases, and descriptive analysis was conducted for clinical parameters.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The rebiopsy rate was 6.5% (841/12,882), with 31.0% (261/841) of rebiopsies due to insufficient specimens. Among these cases, 87.0% (227/261) were stage III–IV, 89.7% (234/261) had poorly differentiated tumors, and 80.1% (209/261) were non-small cell lung cancer (NSCLC). The proportion of molecular testing in stage IV cases was significantly higher than in stage I–III cases (44.8% vs. 25.3%, <i>p</i> = 0.0022). Poorly differentiated cases required significantly more biomarkers in immunohistochemistry and special staining than moderately and well-differentiated cases (8.1 vs. 4.0, <i>p</i> = 0.0039). Insufficient tissue rates were significantly higher in cases with only one biopsy core compared to those with more cores (2.4% vs. 1.5%, <i>p</i> = 0.0088).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Patients with advanced-stage disease, poorly differentiated tumors, and NSCLC undergoing PTNBP are more likely to require rebiopsy due to insufficient specimens. 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引用次数: 0
摘要
背景与目的：计算机断层扫描引导下经皮经胸肺病变穿刺活检（PTNBP）被广泛应用于肺癌的诊断和治疗。然而，由于标本不足以进行明确的病理诊断和分子检测，往往需要重新活检，这增加了患者的负担，降低了治疗效率。本研究旨在探讨再活检的特点，并提出减少不必要的再活检的策略。方法：对2018年1月至2022年12月三个中心共12882例PTNBP病例进行分析。对再活检病例进行归因分析，对临床参数进行描述性分析。结果：再活检率为6.5%(841/ 12882)，其中31.0%（261/841）因标本不足而再活检。其中87.0%（227/261）为III-IV期，89.7%（234/261）为低分化肿瘤，80.1%（209/261）为非小细胞肺癌（NSCLC）。IV期患者分子检测比例显著高于I-III期患者（44.8% vs. 25.3%, p = 0.0022）。低分化病例在免疫组织化学和特殊染色中需要的生物标志物明显多于中分化和高分化病例（8.1 vs. 4.0, p = 0.0039）。只有一个活检针组的组织不足率明显高于有更多活检针组（2.4% vs. 1.5%, p = 0.0088）。结论：晚期疾病、低分化肿瘤和接受PTNBP的非小细胞肺癌患者更有可能因标本不足而需要重新活检。增加活检芯数（≥2个）和实施一站式病理评估管理可有效减少PTNBP患者不必要的重复活检。
A Multicenter Study on Unnecessary Rebiopsies in CT-Guided Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions
Background and Objective
Computed tomography-guided percutaneous transthoracic needle biopsy of pulmonary lesions (PTNBP) is widely used for diagnosing and managing lung cancer. However, rebiopsies are often required due to insufficient specimens for definitive pathological diagnosis and molecular testing, which increase patient burden and reduce treatment efficiency. This study aims to investigate the characteristics of rebiopsies and propose strategies to minimize unnecessary rebiopsies.
Methods
A total of 12,882 PTNBP cases from three centers were analyzed from January 2018 to December 2022. Attribution analysis was conducted for the rebiopsy cases, and descriptive analysis was conducted for clinical parameters.
Results
The rebiopsy rate was 6.5% (841/12,882), with 31.0% (261/841) of rebiopsies due to insufficient specimens. Among these cases, 87.0% (227/261) were stage III–IV, 89.7% (234/261) had poorly differentiated tumors, and 80.1% (209/261) were non-small cell lung cancer (NSCLC). The proportion of molecular testing in stage IV cases was significantly higher than in stage I–III cases (44.8% vs. 25.3%, p = 0.0022). Poorly differentiated cases required significantly more biomarkers in immunohistochemistry and special staining than moderately and well-differentiated cases (8.1 vs. 4.0, p = 0.0039). Insufficient tissue rates were significantly higher in cases with only one biopsy core compared to those with more cores (2.4% vs. 1.5%, p = 0.0088).
Conclusion
Patients with advanced-stage disease, poorly differentiated tumors, and NSCLC undergoing PTNBP are more likely to require rebiopsy due to insufficient specimens. Increasing the number of biopsy cores (≥ 2) and implementing one-stop management for pathological assessment may effectively reduce unnecessary rebiopsies in PTNBP.
期刊介绍：
Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas:
Clinical Cancer Research
Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations
Cancer Biology:
Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery.
Cancer Prevention:
Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach.
Bioinformatics:
Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers.
Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.
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