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
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?
刘宝东1
作者信息
- 1. 100053 北京 首都医科大学宣武医院胸外科
- 折叠
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.
Abstract
In recent years,with the increasing proportion of pulmonary nodules,preoperative percutaneous lung puncture biopsy and bronchoscopic biopsy have received more and more attention.A large amount of clinical evidences indicate that lung puncture biopsy of stageⅠnon-small cell lung cancer(NSCLC)is safe and feasible.However,due to the histological characteristics of pulmonary ground-glass nodule(GGN),puncture biopsy of GGNs is more likely to cause bleeding and cough,and the tumor cells may be implanted along the alveolar wall or needle tract under the impact of blood flow or airflow,leading to the pleural recurrence and tumor spread through air spaces(STAS),when compared with puncture biopsy of solid nodules.Therefore,percutaneous lung puncture biopsy should be carefully adopted,especially for the patients who have subpleural nodules with visceral pleura invasion and lymphocyte infiltration.(J Intervent Radiol,2024,32:7-11)
关键词
肺癌/肺结节/肺活检/胸膜复发/肿瘤气腔播散Key words
lung cancer/pulmonary nodule/lung puncture biopsy/pleural recurrence/tumor spread through air spaces引用本文复制引用
出版年
2024
NETL
NSTL
万方数据