Variability in biopsy quality informs translational research applications in hepatocellular carcinoma.
Variability in biopsy quality informs translational research applications in hepatocellular carcinoma.
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DOI：
10.1038/s41598-021-02093-6
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发表时间：
2021-11-23
影响因子：
4.6
通讯作者：
Gade TPF
中科院分区：
文献类型：
--
作者：
Weinfurtner K;Cho J;Ackerman D;Chen JX;Woodard A;Li W;Ostrowski D;Soulen MC;Dagli M;Shamimi-Noori S;Mondschein J;Sudheendra D;Stavropoulos SW;Reddy S;Redmond J;Khaddash T;Jhala D;Siegelman ES;Furth EE;Hunt SJ;Nadolski GJ;Kaplan DE;Gade TPF
在精准医学时代，活检在癌症研究和治疗模式中发挥着越来越重要的作用;然而，患者结局和活检质量分析以及对下游临床和研究应用的影响仍然被低估。在此，我们报告了作为前瞻性临床试验一部分的肝细胞癌（HCC）经皮穿刺活检的安全性和质量结果。2016年4月至2020年7月，在两个学术医学中心，临床诊断为HCC的患者入选了一项前瞻性队列研究，以进行HCC的遗传学、蛋白质组学和代谢组学分析。在图像引导下，在局部区域治疗时使用同轴技术获得18G核心活检。主要结局是活检质量，定义为核心活检中的肿瘤分数。来自50名患者的56个HCC病灶接受了60次活检事件，每次手术中位值为8次核心活检（四分位距，IQR，7 - 10）。在45/56例（80.4%，4例无病理学）活检事件中确定了肝细胞癌，包括HCC（40/56，71.4%）和胆管癌（CCA）或合并HCC-CCA（5/56，8.9%）。活检质量差异很大，每个活检芯中的肿瘤中位数为40%（IQR 10 - 75）。仅43/56（76.8%）和23/56（41.1%）样本分别符合基因组或代谢组学/蛋白质组学分析的质量阈值，需要扩大临床试验。总体和重大并发症发生率分别为5/60（8.3%）和3/60（5.0%）。尽管活检方案统一，但活检质量差异很大，高达59%的样本不足以达到预期目的。这一发现对临床试验设计具有重要意义，并强调了在应用之前进行质量控制的必要性，其中良性细胞类型的存在可能会大大改变结果。
In the era of precision medicine, biopsies are playing an increasingly central role in cancer research and treatment paradigms; however, patient outcomes and analyses of biopsy quality, as well as impact on downstream clinical and research applications, remain underreported. Herein, we report biopsy safety and quality outcomes for percutaneous core biopsies of hepatocellular carcinoma (HCC) performed as part of a prospective clinical trial. Patients with a clinical diagnosis of HCC were enrolled in a prospective cohort study for the genetic, proteomic, and metabolomic profiling of HCC at two academic medical centers from April 2016 to July 2020. Under image guidance, 18G core biopsies were obtained using coaxial technique at the time of locoregional therapy. The primary outcome was biopsy quality, defined as tumor fraction in the core biopsy. 56 HCC lesions from 50 patients underwent 60 biopsy events with a median of 8 core biopsies per procedure (interquartile range, IQR, 7–10). Malignancy was identified in 45/56 (80.4%, 4 without pathology) biopsy events, including HCC (40/56, 71.4%) and cholangiocarcinoma (CCA) or combined HCC-CCA (5/56, 8.9%). Biopsy quality was highly variable with a median of 40% tumor in each biopsy core (IQR 10–75). Only 43/56 (76.8%) and 23/56 (41.1%) samples met quality thresholds for genomic or metabolomic/proteomic profiling, respectively, requiring expansion of the clinical trial. Overall and major complication rates were 5/60 (8.3%) and 3/60 (5.0%), respectively. Despite uniform biopsy protocol, biopsy quality varied widely with up to 59% of samples to be inadequate for intended purpose. This finding has important consequences for clinical trial design and highlights the need for quality control prior to applications in which the presence of benign cell types may substantially alter findings.
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影响因子：
7.6
作者：
Simmons, O.;Fetzer, D. T.;Singal, A. G.
通讯作者：
Singal, A. G.
影响因子：
45.3
作者：
Brown, Aaron P.;Wendler, David S.;Citrin, Deborah
通讯作者：
Citrin, Deborah
影响因子：
5.8
作者：
El-Osta, Hazem;Hong, David;Kurzrock, Razelle
通讯作者：
Kurzrock, Razelle
影响因子：
25.7
作者：
Durand, F;Regimbeau, JM;Valla, D
通讯作者：
Valla, D
DOI：
10.1158/1078-0432.ccr-17-1449
发表时间：
2017-11-01
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Parseghian CM;Raghav K;Wolff RA;Ensor J Jr;Yao J;Ellis LM;Tam AL;Overman MJ
通讯作者：
Overman MJ