Study On The Application Value Of New Series Of Percutaneous Pulmonary Biopsy Guided By CT In Precision Medicine Of Lung Cancer

Objective: To analyze the relationship between complications such as pneumothorax and hemorrhage occurred in 100 cases of lung cancer with their clinical characteristics and provide evidence to reducing complications by applying new technique of biopsy.Methods: We retrospectively collected the clinical features and imaging data of 100 patients who received percutaneous lung biopsy from September 2016 to December 2017 in cancer center of Nanjing Drum-Tower Hospital.Using the software of SPSS 18.0 to analysis relevant data.Relationships between age,gender,smoking history,the maximum diameter of the lesions and the distance from lesions to chest wall and complications were appraised rank sum test.Results: Biopsy diagnosis rate of PTNB is 99%(99/100).The incidence of pneumothorax was 24%(24/100),bleeding rate was 21%(21/100),and there were no needle tract implantation metastases or air embolism.The incidence of pneumothorax was correlated with the the maximum diameter of the lesions(> 3cm and 3cm)(p=0.033)and there were no significant risk factors in hemorrhage.We concluded that we reduce the risk factors of conventional PTNB for complications by using new biopsy technologies.Conclusion: New PTNB technologies can significantly reduce pneumothorax and hemorrhage.The lesion size is a significant risk factor for pneumothorax after using the new biopsy technique.Objective: Pathology is the gold standard for the diagnosis of tumor.For patients with lung cancer,lung biopsy is still the main diagnostic method.In the guidance of precision medicine,we discussed whether the new technologies of PTNB can improve the tissue acquisition of lung cancer.Methods: A single center prospective single arm clinical study was designed.From February2017 to February 2018,a total of 50 patients were enrolled according to the inclusion criteria and exclusion criteria.All the patients underwent new technologies of PTNB.Side effects including pneumothorax,hemorrhage were observed and pathological type,molecular detection were analyzed.Results: A total of 50 patients were enrolled.The incidence of pneumothorax was 22%(11/50)and hemorrhage was 14 %(7/50),and there were no severe pneumothorax and hemorrhage.45 of the 50 patients were definitely diagnosed with lung cancer including 30 cases adenocarcinoma,3 cases squamous cell carcinoma of the lung,7 cases small cell carcinoma of lung,one right lung adenocarcinoma and left small cell carcinoma of lung and four cases could only be identified as NSCLC,1 case of lung metastasis of renal clear cell carcinoma,1case of lung metastasis of breast cancer,1 case of lung metastasis of intestinal cancer,and 1case of pneumonia.The diagnostic rate of total biopsy was 98%.Molecular detection was performed in 38 patients with NSCLC.EGFR sensitive mutation was 45.5% and positive rate of fusion mutation of ALK gene is 9.1%.Conclusion: In the guidance of precision medicine,the application of new technologies of PTNB could effectively reduce the occurrence of pneumothorax and hemorrhage and could ensure the puncture tissue acquisition,so that patients can obtain reliable molecular diagnosis.Therefore,new technologies of PTNB can be applied to more patients for further observation of its safety and effectiveness.