Our Summary

This research study looked at how effective a certain type of lung biopsy can predict the type of lung cancer (adenocarcinoma) and the patient’s outcome after surgery. A biopsy is when a small piece of tissue is removed from the body to examine it for disease. In this case, the researchers used a method called computed tomography-guided core needle biopsy, where a needle is guided by a CT scan to take a small sample of lung tissue.

The researchers looked back at 221 patients who had this type of biopsy and then had surgery to remove their cancer. They compared the results of the biopsy with the results of the examination of the whole cancer after it was surgically removed. They found that in 77% of the cases, the biopsy correctly identified the main type of cancer.

When predicting less aggressive types of cancer, the biopsy was correct 93% of the time, while for more aggressive types, it was correct 48% of the time. The study also found that the longer the sample taken during the biopsy, and the more of the cancer was made up of a specific subtype, the more likely the biopsy was to be correct.

Moreover, if the biopsy found a more aggressive type of cancer, this was a good predictor that the disease would progress after surgery.

This suggests that this type of biopsy could help doctors plan surgery for lung cancer patients, but more research is needed to confirm this.

FAQs

  1. How effective are computed tomography-guided core needle biopsies in predicting the histologic subtype of lung adenocarcinoma?
  2. What factors can impact the diagnostic sensitivity of computed tomography-guided core needle biopsies for lung adenocarcinoma?
  3. Can a lung biopsy predict lung adenocarcinoma progression after surgical resection?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lung biopsy is to ensure they understand the importance of the procedure in guiding treatment decisions. It is important for patients to follow their doctor’s recommendations for a lung biopsy, as the results can help determine the best course of action for their specific condition. Additionally, patients should be aware of the potential risks and benefits of the procedure, and should feel comfortable discussing any concerns or questions with their healthcare provider.

Suitable For

Patients who are typically recommended for a lung biopsy are those with suspected or confirmed lung adenocarcinoma who are candidates for surgical resection. In this study, patients with lung adenocarcinoma underwent computed tomography-guided core needle biopsy to determine histologic subtype and guide surgical planning. The study found that core biopsy specimens had a high concordance with surgically resected specimens in predicting histologic subtype and patient outcomes. Patients with aggressive subtypes identified in biopsy specimens were at higher risk for progression after surgery. Therefore, lung biopsy may be recommended for patients with lung adenocarcinoma to help predict outcomes and guide treatment decisions.

Timeline

Before lung biopsy:

  1. Patient undergoes imaging studies such as computed tomography (CT) scan to identify suspicious lung nodules or masses.
  2. Patient consults with a healthcare provider to discuss the need for a lung biopsy and the potential risks and benefits.
  3. If deemed necessary, patient schedules a CT-guided core needle biopsy procedure.
  4. Patient may undergo pre-procedure blood tests and imaging to assess suitability for the biopsy.
  5. Patient receives instructions on fasting and medication use before the biopsy procedure.

After lung biopsy:

  1. Patient arrives at the hospital or clinic for the CT-guided core needle biopsy procedure.
  2. Local anesthesia is administered, and a needle is inserted into the lung to obtain tissue samples.
  3. Patient may experience mild discomfort or pain during the procedure.
  4. Biopsy samples are sent to the pathology lab for analysis.
  5. Patient is monitored for any complications or side effects post-procedure.
  6. Results of the biopsy are communicated to the patient by their healthcare provider.
  7. Based on the biopsy results, further treatment options such as surgery, radiation therapy, or chemotherapy may be recommended.
  8. Patient may undergo surgical resection of the lung tumor if necessary, based on the biopsy findings.
  9. Post-surgical follow-up appointments are scheduled to monitor patient recovery and response to treatment.

What to Ask Your Doctor

  1. What is the purpose of a lung biopsy in my specific case?
  2. What are the potential risks and complications associated with a lung biopsy procedure?
  3. How will the results of the biopsy impact my treatment plan and prognosis?
  4. How accurate is the biopsy in determining the histologic subtype of my lung adenocarcinoma?
  5. Will the biopsy results help guide surgical planning for my condition?
  6. How long will it take to receive the results of the biopsy?
  7. What factors may affect the accuracy of the biopsy results?
  8. How does the presence of an aggressive subtype in the biopsy specimen impact my risk of disease progression after surgery?
  9. Are there alternative methods for determining the histologic subtype of my lung adenocarcinoma?
  10. What further steps should I take based on the results of the biopsy?

Reference

Authors: Kim TH, Buonocore D, Petre EN, Durack JC, Maybody M, Johnston RP, Travis WD, Adusumilli PS, Solomon SB, Ziv E. Journal: Ann Thorac Surg. 2019 Aug;108(2):392-398. doi: 10.1016/j.athoracsur.2019.03.043. Epub 2019 Apr 12. PMID: 30986416