CT引导下穿刺活检对ⅠA期非小细胞肺癌疾病无进展生存期和总生存期的影响

The influence of CT-guided needle biopsy on disease-free progressive survival and overall survival in patients with stage ⅠA non-small cell lung cancer

目的探讨ⅠA期非小细胞肺癌(NSCLC)患者根治术术前活检是否影响患者的疾病无进展生存期(PFS)和总生存期(OS)。方法回顾性收集2007-2014年行根治术的ⅠA期NSCLC患者225例,根据是否行CT引导下穿刺活检,依临床基本特征进行1∶1倾向性匹配分析(PSM),活检组和非活检组分别有47例纳入研究。采用Kaplan-Meier生存曲线和Cox回归分析进行生存分析。结果经PSM匹配后两组基本临床资料无显著差异。匹配后中位随访时间58.5个月,活检组和非活检组的PFS分别为(64.8±31.4)和(61.2±34.4)个月,两组PFS差异无统计学意义(χ~2=0.020,P=0.888),OS分别为(67.9±30.2)、(65.3±31.3)个月,差异无统计学意义(χ~2=0.003,P=0.955)。单因素和多因素分析显示根治术术前行CT引导下经皮穿刺活检不是患者PFS和OS的影响因素。结论ⅠA期NSCLC术前行CT引导下经皮穿刺活检不影响患者的PFS和OS。

Objective To investigate the influence of needle biopsy performed before radical surgery on the progress-free survival(PFS) and overall survival(OS) in patients with stage ⅠA non-small cell lung cancer(NSCLC). Methods A total of 255 patients with stage ⅠA NSCLC, who received radical resection of pulmonary carcinoma at authors’ hospital during the period from 2007 to 2014, were collected. According to whether or not CT-guided needle biopsy was performed and based on the basic clinical characteristics, 1:1 propensity score matching(PSM) analysis was conducted. There were 47 patients in the biopsy group as well as in the non-biopsy group. Kaplan-Meier survival curve and the Cox regression analysis were used to make survival analysis. Results After PSM, there were no significant differences in basic clinical data between the two groups. The median follow-up time was 58.5 months. The PFS in the biopsy group and nonbiopsy group was(64.8±31.4) months and(61.2±34.4) months respectively, the difference between the two groups was not statistically significant(χ~2=0.020, P=0.888). The OS in the biopsy group and non-biopsy group was(67.9±30.2) months and(65.3±31.3) months respectively, the difference between the two groups was not statistically significant(X^2=0.003, P=0.955). The univariate and multivariate analysis indicated that preoperative CT-guided needle biopsy was not the factor affecting PFS and OS. Conclusion Preoperative CT-guided needle biopsy has no effect on PFS or OS in patients with stage ⅠA NSCLC.