Pathologic Diagnosis and Genetic Analysis of a Lung Tumor Needle Biopsy Specimen Obtained Immediately After Radiofrequency Ablation
Pathologic Diagnosis and Genetic Analysis of a Lung Tumor Needle Biopsy Specimen Obtained Immediately After Radiofrequency Ablation
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DOI：
10.1007/s00270-017-1845-4
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发表时间：
2018-04-01
影响因子：
2.9
通讯作者：
Yatabe, Yasushi
中科院分区：
文献类型：
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作者：
Hasegawa, Takaaki;Kondo, Chiaki;Yatabe, Yasushi
目的探讨射频消融术（RFA）后立即获得的经皮穿刺活检（CNB）肺肿瘤标本的病理诊断和基因分析的可能性。分析2013年5月至2016年5月RFA术后立即行肺肿瘤CNB的患者。19例患者（男8例，女11例，年龄中位数69岁，范围52 ~ 88岁），19例肺肿瘤直径0.5 ~ 2.6 cm（中位数1.6 cm）。13个肿瘤为实性，6个主要为磨玻璃影（GGO）。所有标本病理检查使用苏木精和伊红（H&E）染色和额外的免疫染色，如有必要。对标本进行EGFR和KRAS基因突变分析。评估手术的安全性、技术成功率、病理诊断和基因突变分析的可能性。主要和次要并发症发生率分别为11%（2/19）和53%（10/19）。成功获得肿瘤细胞16例（84%,16/19），而技术成功率（50%,3/6）明显低于实性病变（100%,13/13,p = 0.02）。79%（15/19）的病例仅通过H&E染色（n = 12）和附加免疫染色（n = 3）进行病理诊断。虽然获得非典型细胞，但1例（5%,1/19）未得到病理诊断。在74%（14/19）的标本中均可检测到EGFR和KRAS突变。即使对RFA后立即获得的肺肿瘤标本也可进行病理诊断和遗传分析。
To evaluate the possibility of pathologic diagnosis and genetic analysis of percutaneous core-needle biopsy (CNB) lung tumor specimens obtained immediately after radiofrequency ablation (RFA).Patients who underwent CNB of lung tumors immediately after RFA from May 2013 to May 2016 were analyzed. There were 19 patients (8 men and 11 women; median age, 69 years; range, 52-88 years) and 19 lung tumors measuring 0.5-2.6 cm (median, 1.6 cm). Thirteen tumors were solid, and 6 were predominantly ground-glass opacity (GGO) on computed tomography. All specimens were pathologically examined using hematoxylin and eosin (H&E) staining and additional immunostaining, as necessary. The specimens were analyzed for EGFR and KRAS genetic mutations. The safety and technical success rate of the procedure and the possibility of pathologic diagnosis and genetic mutation analysis were evaluated.Major and minor complication rates were 11% (2/19) and 53% (10/19), respectively. Tumor cells were successfully obtained in 16 cases (84%, 16/19), and technical success rate was significantly lower for GGO-dominant tumors (50%, 3/6) compared with solid lesions (100%, 13/13, p = 0.02). Pathologic diagnosis was possible in 79% (15/19) of cases based on H&E staining alone (n = 12) and with additional immunostaining (n = 3). Although atypical cells were obtained, pathologic diagnosis could not be achieved in 1 case (5%, 1/19). Both EGFR and KRAS mutations could be analyzed in 74% (14/19) of the specimens.Pathologic diagnosis and genetic analysis could be performed even for lung tumor specimens obtained immediately after RFA.