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The Journal of Thoracic and... Jan 2022
Topics: Biopsy, Needle; Consensus; Endosonography; Humans
PubMed: 33824021
DOI: 10.1016/j.jtcvs.2021.03.042 -
Thoracic Cancer Jun 2022Genomic testing is the cornerstone of the treatment of patients with non-small-cell lung cancer. However, comprehensive molecular testing of small specimens may be...
BACKGROUND
Genomic testing is the cornerstone of the treatment of patients with non-small-cell lung cancer. However, comprehensive molecular testing of small specimens may be inadequate due to limited tissue. Liquid biopsy has emerged as a new method of genotyping. In this study, we evaluate the feasibility of using supernatants from core needle biopsy samples of lung adenocarcinoma for genomic testing.
METHODS
Core needle biopsy specimens and their supernatants were collected from patients (n = 48) with lung adenocarcinoma. Genomic testing results of the supernatant samples were compared with results derived from paired tissue samples from the same patient.
RESULT
All 48 supernatant samples yield adequate cell-free DNA, but the concentration of cell-free RNA did not meet the criteria for analysis. The concordance rate between the genomic testing results of supernatants and the corresponding tissue samples was 95.8% (kappa = 0.899). The coincidence rate of detectable mutations at the DNA level in the supernatants was up to 100%.
CONCLUSION
Core needle biopsy supernatants can provide a valuable specimen source for genotyping pulmonary adenocarcinoma. However, the method of preserving and extracting RNA from supernatant specimens needs further improvement.
Topics: Adenocarcinoma of Lung; Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Carcinoma, Non-Small-Cell Lung; Cell-Free Nucleic Acids; Humans; Liquid Biopsy; Lung Neoplasms
PubMed: 35575062
DOI: 10.1111/1759-7714.14461 -
World Journal of Gastroenterology Jul 2021Endoscopic ultrasound tissue acquisition, in the form of both fine needle aspiration (EUS-FNA) and fine needle biopsy (EUS-FNB), is utilized for pancreatic mass lesions,... (Review)
Review
Endoscopic ultrasound tissue acquisition, in the form of both fine needle aspiration (EUS-FNA) and fine needle biopsy (EUS-FNB), is utilized for pancreatic mass lesions, subepithelial lesions, and lymph node biopsy. Both procedures are safe and yield high diagnostic value. Despite its high diagnostic yield, EUS-FNA has potential limitations associated with cytological aspirations, including inability to determine histologic architecture, and a small quantitative sample for further immunohistochemical staining. EUS-FNB, with its larger core biopsy needle, was designed to overcome these potential limitations. However, it remains unclear which technique should be used and for which lesions. Comparative trials are plagued by heterogeneity at every stage of comparison; including variable needles used, and different definitions of endpoints, which therefore limit generalizability. Thus, we present a review of prospective trials, systematic reviews, and meta-analyses on studies examining EUS-FNA EUS-FNB. Prospective comparative trials of EUS-FNA EUS-FNB primarily focus on pancreatic mass lesions, and yield conflicting results in terms of demonstrating the superiority of one method. However, consistent among trials is the potential for diagnosis with fewer passes, and a larger quantity of sample achieved for next generation sequencing. With regard to subepithelial lesions and lymph node biopsy, fewer prospective trials exist, and larger prospective studies are necessary. Based on the available literature, we would recommend EUS-FNB for peri-hepatic lymph nodes.
Topics: Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography; Humans; Lymph Nodes; Needles; Pancreatic Neoplasms; Prospective Studies
PubMed: 34326619
DOI: 10.3748/wjg.v27.i26.4194 -
Journal of Healthcare Engineering 2022The number of patients with lung cancer is difficultly diagnosed in the early stage. The purpose of the study was to investigate the effects of CT- and ultrasound-guided...
The number of patients with lung cancer is difficultly diagnosed in the early stage. The purpose of the study was to investigate the effects of CT- and ultrasound-guided percutaneous transthoracic needle biopsy combined with serum CA125 and CEA on the diagnosis of lung cancer. 120 patients with suspected lung cancer admitted to our hospital from January 2019 to January 2020 were selected and divided into an ultrasound group ( = 60) and CT group ( = 60), according to different percutaneous transthoracic needle biopsy modalities. All patients received serum tumor markers detection, so as to compare the CT- and ultrasound-guided percutaneous transthoracic needle biopsy results and pathology results, levels of serum tumor markers among all patients and the patients with different lung cancer types, and diagnostic efficacy of tumor markers, as well as complication rate (CR) in patients. The sensitivity and specificity of ultrasound-guided percutaneous transthoracic needle biopsy were 0.880 and 0.800, respectively, while those of CT-guided percutaneous transthoracic needle biopsy were 0.909 and 0.625, respectively; the CA125 and CEA levels in the lung cancer group were higher than those in the benign group ( < 0.001); the CA125 and CEA levels of the patients with adenocarcinoma were higher than those with squamous carcinoma, and the CEA levels of the patients with small-cell carcinoma were lower than those with adenocarcinoma ( < 0.05); the sensitivity, specificity, and Youden indexes of CA125 were 0.638, 0.833, and 0.471, respectively, while those of CEA were 0.766, 0.778, and 0.544, respectively; there were no significant differences in CR between the two groups ( > 0.05). CT- and ultrasound-guided percutaneous transthoracic needle biopsy is a safe and feasible diagnostic modality for lung cancer, and its combination with serum CA125 and CEA can significantly improve the accuracy of the detection results, which is worthy of promotion and application in clinical practice.
Topics: Adenocarcinoma; Biomarkers, Tumor; Biopsy, Needle; Carcinoembryonic Antigen; Humans; Lung Neoplasms; Tomography, X-Ray Computed; Ultrasonography, Interventional
PubMed: 35035813
DOI: 10.1155/2022/2289432 -
Korean Journal of Radiology Feb 2022To compare core needle biopsy (CNB) and repeat fine-needle aspiration (rFNA) to reduce the rate of diagnostic surgery and prevent unnecessary surgery in nodules...
Comparison of Core Needle Biopsy and Repeat Fine-Needle Aspiration in Avoiding Diagnostic Surgery for Thyroid Nodules Initially Diagnosed as Atypia/Follicular Lesion of Undetermined Significance.
OBJECTIVE
To compare core needle biopsy (CNB) and repeat fine-needle aspiration (rFNA) to reduce the rate of diagnostic surgery and prevent unnecessary surgery in nodules initially diagnosed as atypia/follicular lesions of undetermined significance (AUS/FLUS).
MATERIALS AND METHODS
This study included 231 consecutive patients (150 female and 81 male; mean age ± standard deviation, 51.9 ± 11.7 years) with 235 thyroid nodules (≥ 1 cm) initially diagnosed as AUS/FLUS, who later underwent both rFNA and CNB. The nodules that required diagnostic surgery after the biopsy were defined using three different scenarios according to the rFNA and CNB results: criterion 1, surgery for low-risk indeterminate (categories I and III); criterion 2, surgery for high-risk indeterminate (categories IV and V); and criterion 3, surgery for all indeterminate nodules (categories I, III, IV, and V). We compared the expected rates of diagnostic surgery between CNB and rFNA in all 235 nodules using the three surgical criteria. In addition, the expected rates of unnecessary surgery (i.e., surgery for benign pathology) were compared in a subgroup of 182 nodules with available final diagnoses.
RESULTS
CNB showed significantly lower rates of nondiagnostic, AUS/FLUS, and suspicious for malignancy diagnoses ( ≤ 0.016) and higher rates of follicular neoplasm or suspicious for a follicular neoplasm ( < 0.001) and malignant diagnoses ( = 0.031). CNB showed a significantly lower expected rate of diagnostic surgery than rFNA for criterion 1 (29.8% vs. 48.1%, < 0.001) and criterion 3 (46.4% vs. 55.3%, = 0.029), and a significantly higher rate for criterion 2 (16.6% vs. 7.2%, = 0.001). CNB showed a significantly lower expected rate of unnecessary surgery than rFNA for criterion 1 (18.7% vs. 29.7%, = 0.024).
CONCLUSION
CNB was superior to rFNA in reducing the rates of potential diagnostic surgery and unnecessary surgery for nodules initially diagnosed as AUS/FLUS in a scenario where nodules with low-risk indeterminate results (categories I and III) would undergo surgery.
Topics: Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Female; Humans; Male; Retrospective Studies; Thyroid Neoplasms; Thyroid Nodule
PubMed: 35029081
DOI: 10.3348/kjr.2021.0619 -
Gastrointestinal Endoscopy Feb 2022
Topics: Biopsy, Large-Core Needle; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography; Humans; Image-Guided Biopsy; Liver
PubMed: 34678299
DOI: 10.1016/j.gie.2021.10.016 -
Digestive and Liver Disease : Official... Dec 2020Liver biopsy remains essential for the diagnostic work-up of patients with liver disease. (Comparative Study)
Comparative Study
BACKGROUND
Liver biopsy remains essential for the diagnostic work-up of patients with liver disease.
AIMS
To evaluate aspiration vs. core-biopsy needles for transjugular liver biopsy (TJLB) in patients undergoing hepatic venous pressure gradient (HVPG) measurements.
METHODS
84 patients undergoing TJLB between 06/2017 and 12/2018 were prospectively included. Liver biopsy specimens were systematically evaluated for quantitative and qualitative criteria such as number of portal tracts, sample length and fragmentation.
RESULTS
In direct comparison of paired TJLB specimens (n=35), core-biopsy samples were significantly longer (median 12 vs. 9mm, p=0.012), tended to contain more portal tracts (median 8 vs. 6, p=0.064) and were less fragmented (p<0.001), which resulted in better confidence for liver fibrosis assessment (p=0.035). However, a superior quality in terms of less fragmentation of core-biopsy specimens (p<0.05) was only confirmed in patients with HVPG ≥10mmHg or liver stiffness measurement >40kPa. In contrast, the aspiration needle provided significantly longer samples in patients with HVPG <10mmHg (median 21 vs. 12mm, p=0.007) or with liver stiffness measurement <20kPa (median 21 vs. 11mm, p=0.025).
CONCLUSION
In patients with HVPG ≥10mmHg, we recommend to performed TJLB using core-biopsy needles, while the aspiration needle provides high quality liver biopsy specimens in patients with HVPG <10mmHg.
Topics: Adult; Biopsy, Needle; Female; Humans; Jugular Veins; Liver; Liver Cirrhosis; Liver Diseases; Liver Transplantation; Male; Middle Aged; Portal Pressure; Portal System
PubMed: 32928675
DOI: 10.1016/j.dld.2020.08.028 -
Journal of Cancer Research and... Aug 2023The purpose of this study was to assess computed tomography (CT)-guided puncture biopsy of pulmonary nodules at a high risk of bleeding. First, a coaxial trocar...
CONTEXT
The purpose of this study was to assess computed tomography (CT)-guided puncture biopsy of pulmonary nodules at a high risk of bleeding. First, a coaxial trocar technique was used to radiofrequency ablate small blood vessels in the puncture area, followed by a biopsy of the pulmonary nodule.
AIM
This study aimed to evaluate the effectiveness and safety of this procedure.
METHODS
In this retrospective research, we assessed the relevant data of 45 patients who had undergone needle biopsy of pulmonary nodules at a high risk of bleeding. Twenty-five of these patients had CT-guided coaxial radiofrequency ablation (RFA)-assisted biopsy (group A). The remaining 20 had undergone conventional CT-guided needle biopsy (group B). We equated the technical success rate and the incidence of complications such as bleeding, pneumothorax, and pain in the two groups of needle biopsies.
RESULTS
Both groups had a 100% success rate with puncture biopsy. The incidences of pneumothorax in groups A and B were 10% (2/20) and 24% (6/25), respectively; this difference is not significant (P > 0.050). The rates of bleeding in groups A and B were 10% (2/20) and 44% (11/25), respectively, and the rates of pain were 30% (6/20) and 60% (15/25), both of which were statistically significant (P = 0.030; P = 0.045, respectively).
CONCLUSIONS
CT-guided coaxial trocar technique for RFA-assisted biopsy of pulmonary nodules at a high risk of bleeding is effective and safe and can significantly reduce the risk of biopsy-induced pulmonary hemorrhage.
Topics: Humans; Pneumothorax; Retrospective Studies; Hemorrhage; Image-Guided Biopsy; Multiple Pulmonary Nodules; Pain; Radiofrequency Ablation
PubMed: 37675725
DOI: 10.4103/jcrt.jcrt_2193_22 -
Sensors (Basel, Switzerland) Jan 2023Lung cancer is the leading cause of cancer deaths worldwide. Although several lung cancer diagnostic methods are available for lung nodule biopsy, there are limitations...
Lung cancer is the leading cause of cancer deaths worldwide. Although several lung cancer diagnostic methods are available for lung nodule biopsy, there are limitations in terms of accuracy, safety, and invasiveness. Transbronchial needle aspiration (TBNA) is a common method for diagnosing and treating lung cancer that involves a robot-assisted medical flexible needle moving along a curved three-dimensional trajectory, avoiding anatomical barriers to achieve clinically meaningful goals in humans. Inspired by the puncture angle between the needle tip and the vessel in venipuncture, we suggest that different orientations of the medical flexible needle puncture path affect the cost of the puncture trajectory and propose an effective puncture region based on the optimal puncture direction, which is a strategy based on imposing geometric constraints on the search space of the puncture direction, and based on this, we focused on the improved implementation of RCS*. Planning within the TBNA-based lung environment was performed using the rapidly exploring random tree (RRT), resolution-complete search (RCS), and RCS* (a resolution-optimal version of RCS) within an effective puncture region. The experimental results show that the optimal puncture direction corresponding to the lowest cost puncture trajectory is consistent among the three algorithms and RCS* is more efficient for planning. The experiments verified the feasibility and practicality of our proposed minimum puncture angle and puncture effective region and facilitated the study of the puncture direction of flexible needle puncture.
Topics: Humans; Needles; Lung; Lung Neoplasms; Biopsy, Fine-Needle; Phlebotomy
PubMed: 36679469
DOI: 10.3390/s23020671 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2021The aim of the research is to increase the effectiveness of preoperative diagnosis of patients with thyroid tumors and to assess the use of cancer-embryonic antigen and...
OBJECTIVE
The aim of the research is to increase the effectiveness of preoperative diagnosis of patients with thyroid tumors and to assess the use of cancer-embryonic antigen and immunocytochemical research.
PATIENTS AND METHODS
Materials and methods: Patients were interviewed about their complaints and lifestyle; performed ultrasound with fine-needle aspiration, determination of the level of cancer-embryonic antigen (CEA), cytological and immunocytochemical researches.
RESULTS
Results: The Benign process in the thyroid gland is low serum REA (less than 0.95 ng / ml), poor expression of thyroglobulin (77.8%), negative reaction with TTF-1 (100%) and cytokeratin-19 (55.6%). Differential-prognostic markers of thyroid neoplasms with risk of malignancy include increased serum REA (0.95 ng / ml and above), the presence of a moderate reaction with antibodies to thyroglobulin (80.0%), a positive reaction - to TTF-1 (100.0%) and E-cadherin (90.0%), with moderate or strong expression of cytokeratin-19 (90.0%). Statistically significant markers of malignant thyroid disease were determined: the presence of harmful factors at work (45.5%), smoking (27.3%), elevated serum REA (0.95 ng / ml and above), the presence of strong cytoplasmic expression of thyroglobulin (63.6%), moderate or strong expression of TTF-1 (90.9%) and cytokeratin-19 (81.8%).
CONCLUSION
Conclusions: The most appropriate and practically significant for preoperative diagnosis of thyroid tumors is a set of several diagnostic methods, which are carried out in one hospital - ultrasound with fine-needle aspiration, cytomorphological, and immunocytochemical and REA levels in a primary screening.
Topics: Biopsy, Fine-Needle; Humans; Prohibitins; Thyroglobulin; Thyroid Diseases; Thyroid Neoplasms
PubMed: 33813463
DOI: No ID Found