背景与目的 CT引导下穿刺活检(computed tomography-guided needle biopsy,CTNB)是诊断肺癌最常用的一种方法,具有诊断准确性高及并发症少的特点.现有的研究表明CTNB可引起肿瘤的针道转移,然而极少有研究关注CTNB对远处转移和远期生存的影响.本研究旨在探讨术前的CTNB对I期-II期非小细胞肺癌(non-small cell lung cancer,NSCLC)远处转移和生存的影响.方法研究对象为1,234例I期-II期NSCLC术后患者,其中113例术前行CTNB,1,121例术前未经任何活检.应用倾向性评分匹配方法平衡两组间的临床特征,经配对后纳入后续统计检验共226例.并进一步应用Cox回归分析法和Kaplan-Meier分析法进行生存分析.结果在I期-II期NSCLC患者中,术前的CTNB组无远处转移时间(distant metastasis free survival,DMFS)显著短于无活检组(P=0.032),而两组间总生存无统计学差异(P=0.086).结论CT引导下穿刺肺活检可能促进早期肺癌的远处转移,但不影响总生存.%Background and objectiveComputed tomography-guided needle biopsy (CTNB) is a well-established and commonly used technique for diagnosing pulmonary nodules with high accuracy and safety. Needle-tract implantation after CTNB has been reported in various reports. The aim of this study is to evaluate whether preoperative CTNB affected the distant metastasis and overall survival in pathological stage I-II lung cancer patients.Methods A total of 1,234 patients with pathological stage I-II non-small cell lung cancer were collected. 113 patients received preoperative CTNB, and 1,121 patients did not receive any biopsy before surgical resection. Propensity score-matching method was adopted to balance observed co-variates between two groups, 113 pairs were matched.Cox regression analysis andKaplan-Meier estimates were used to process survival analysis.Results Distant metastasis free survival (DMFS) was significantly poorer in the preoperative CTNB group than in the non-biopsy group (P=0.032). But there was no difference in the overall survival between the two groups (P=0.086). Conclusion CTNB increased the risk of distant metastasis, not increasing the risk of mortality.
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