关于术前生物检验对肺癌患者术后复发和转移的影响，仍存在争议。为了阐明这些争议，我们收集了相关文献进行了荟萃分析。为验证荟萃分析结果，我们进行了回顾性分析，使用倾向性评分匹配和竞争风险模型对我们中心2010年至2018年接受手术切除的575例一期肺腺癌患者进行了分析。荟萃分析包括11篇文章共5509例肺癌患者。总结分析显示，生物检验组的总复发率高于无检验组（风险比1.690，95% CI 1.220-2.330；p=0.001）。在倾向性评分匹配后，我们发现生物检验与总复发之间无显著相关性（风险比1.070，95% CI 0.540-2.120；p=0.850）。在我们的队列中，575例一期肺腺癌中，113例（19.7%）患者接受了术前生物检验。在中位（四分位数范围）随访时间为71（57-93）个月内，多变量分析显示，术前生物检验在整体观察队列（亚群分布风险比（SHR）1.522，95% CI 0.997-2.320；p=0.051）和倾向性评分匹配队列（SHR 1.134，95% CI 0.709-1.810；p=0.600）中与复发和转移的风险无显著相关性。此外，术前生物检验不影响无病生存（SHR 0.853，95% CI 0.572-1.273；p=0.438）和总体生存（SHR 0.647，95% CI 0.352-1.189；p=0.161）。术前生物检验可能不增加复发和转移的风险，这表明对于一期肺腺癌在手术前难以确定诊断的患者而言，这些检验可能是安全的。版权所有©作者，2023年。

Whether pre-operative biopsy affects post-operative recurrence and metastasis of lung cancer patients is still controversial.In order to clarify these disputes, we collected relevant literature to conduct a meta-analysis. To validate the results of the meta-analysis, we retrospectively analysed 575 patients with stage I lung adenocarcinoma who underwent surgical resection at our centre from 2010 to 2018 using propensity score matching and competing risk models.5509 lung cancer patients from 11 articles were included in the meta-analysis. Summary analysis showed that the total recurrence rate of the biopsy group was higher than that of the nonbiopsy group (risk ratio 1.690, 95% CI 1.220-2.330; p=0.001). After propensity score matching, we found that there was no significant correlation between biopsy and total recurrence (risk ratio 1.070, 95% CI 0.540-2.120; p=0.850). In our cohort, of 575 stage I lung adenocarcinomas, 113 (19.7%) patients underwent pre-operative biopsy. During a median (interquartile range) follow-up of 71 (57-93) months, multivariable analyses showed pre-operative biopsy in the overall observation cohort (subdistribution hazard ratio (SHR) 1.522, 95% CI 0.997-2.320; p=0.051) and in the propensity score-matched cohort (SHR 1.134, 95% CI 0.709-1.810; p=0.600) was not significantly correlated with the risk of recurrence and metastasis. Moreover, the pre-operative biopsy did not affect disease-free survival (SHR 0.853, 95% CI 0.572-1.273; p=0.438) or overall survival (SHR 0.647, 95% CI 0.352-1.189; p=0.161).Pre-operative biopsy might not increase the risk of recurrence and metastasis, suggesting that these procedures might be safe for patients with stage I lung adenocarcinoma whose diagnosis is difficult to determine before surgery.Copyright ©The authors 2023.