Lung Cancer Diagnosis by Fine Needle Aspiration Is Associated With Reduction in Resection of Nonmalignant Lung Nodules.
Lung Cancer Diagnosis by Fine Needle Aspiration Is Associated With Reduction in Resection of Nonmalignant Lung Nodules.
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DOI：
10.1016/j.athoracsur.2016.11.055
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发表时间：
2017-06
影响因子：
4.6
通讯作者：
Powell, Charles A.
中科院分区：
文献类型：
--
作者：
Barta, Julie A.;Henschke, Claudia I.;Flores, Raja M.;Yip, Rowena;Yankelevitz, David F.;Powell, Charles A.
术前怀疑为肺癌的非恶性肺结节的切除率差异很大，据报道高达40%。我们确定了频繁使用计算机断层扫描（CT）引导下细针穿刺（FNA）对在学术医学中心接受肺癌切除术评估的患者中非恶性结节切除率和良性疾病切除率的影响。合格患者在2013年7月至2014年7月的12个月期间接受了CT引导下FNA、手术切除或两者兼而有之，用于已知或疑似首次原发可切除的I-III期肺癌。从电子病历中提取患者数据。手术切除197例，其中非恶性病变切除率为13.1%（26/197）。对于术前进行FNA的患者，发生率为7.9%（11/139），对于未进行活检的患者，发生率为25.9%（15/58）（p = 0.001）。细针穿刺活检的敏感性和特异性分别为96%和98%。假阴性率为3.9%（5/128）。术前行CT引导下细针穿刺活检的患者非恶性淋巴结切除率明显低于未行活检的患者。FNA在这些中高危肺癌患者中的诊断准确性高于正电子发射断层扫描，不良事件发生率低。这些结果表明，经常使用术前诊断证实FNA的结果在一个低的非恶性切除率。
The rates of resection of nonmalignant lung nodules suspected preoperatively to be lung cancer vary widely and are reported to be as high as 40%. We determined the impact of the frequent use of computed tomography (CT)-guided fine needle aspiration (FNA) on the resection rate of nonmalignant nodules and frequency of resections of benign disease among patients undergoing evaluation for lung cancer resection operation in an academic medical center. Eligible patients underwent CT-guided FNA, surgical resection, or both during the 12-month period between July 2013 and July 2014 for known or suspected first primary resectable stage I–III lung cancer. Patient data were extracted from the electronic medical records. One hundred ninety-seven patients underwent surgical resection; among them the overall resection rate of nonmalignant lesions was 13.1% (26/197). For those with preoperative FNA, the rate was 7.9% (11/139), and for those with no biopsy, the rate was 25.9% (15/58) (p = 0.001). The sensitivity and specificity of FNA biopsy were 96% and 98%, respectively. The false-negative rate was 3.9% (5/128). The resection rate of nonmalignant nodes rate was significantly lower for patients with preoperative CT-guided FNA biopsy than in those without. The diagnostic accuracy of FNA in these patients at moderate to high risk for lung cancer is higher than that of positron emission tomography, with a low rate of adverse events. These findings suggest that the frequent use of preoperative diagnostic confirmation by FNA results in a low rate of nonmalignant resection.
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影响因子：
39.2
作者：
Wiener RS;Schwartz LM;Woloshin S;Welch HG
通讯作者：
Welch HG
影响因子：
4.6
作者：
Deppen, Stephen A.;Davis, William T.;Grogan, Eric L.
通讯作者：
Grogan, Eric L.
影响因子：
4.6
作者：
Smith, MA;Battafarano, RJ;Benfield, JR
通讯作者：
Benfield, JR
DOI：
10.1016/j.athoracsur.2010.08.054
发表时间：
2011-01
期刊：
The Annals of thoracic surgery
影响因子：
--
作者：
Isbell JM;Deppen S;Putnam JB Jr;Nesbitt JC;Lambright ES;Dawes A;Massion PP;Speroff T;Jones DR;Grogan EL
通讯作者：
Grogan EL
影响因子：
20.4
作者：
Field, John K.;Smith, Robert A.;Mulshine, Jim L.
通讯作者：
Mulshine, Jim L.