肺肿瘤的组织学确认是治疗计划的先决条件。人们怀疑 CT 引导下的针吸活检 (CTGNB) 会使患者面临更高的胸膜复发风险。然而，在比较 CTGNB 与支气管镜检查时，肿瘤与胸膜之间的距离在很大程度上被忽视，因为它是一个可能的混杂因素。2010 年至 2020 年间，所有经支气管镜检查或 CTGNB 组织学证实的肺癌患者均被纳入研究。回顾了患者的病史、放射学和病理学结果以及手术记录。胸膜复发通过胸膜活检、液体细胞学或 CT 胸部成像显示进行性胸膜结节来诊断。在这项回顾性单中心分析中，2010 年至 2020 年间，844 名患者接受了早期肺癌的根治性切除术。中位随访时间为 47.5 个月（3-137）。确定了 27 名患者 (3.2%) 患有同侧胸膜复发 (IPR)。接受 CTGNB 的患者肿瘤到胸膜的距离明显更小。位于下叶的肿瘤存在 IPR 风险增加的趋势（HR：2.18 [±0.43]，p = 0.068），但只有微观胸膜侵犯是 IPR 风险增加的显着独立预测因素（HR：5.33） [± 0.51]，p = 0.001）通过多变量 cox 分析。 CTGNB 活检不会影响 IPR（HR：1.298 [± 0.39]，p = 0.504）。CTGNB 是安全的，并且与我们的患者队列中 IPR 发生率增加无关。这一观察结果仍有待在更大的多中心患者队列中进行验证。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

Histological confirmation of a lung tumor is the prerequisite for treatment planning. It has been suspected that CT-guided needle biopsy (CTGNB) exposes the patient to a higher risk of pleural recurrence. However, the distance between tumor and pleura has largely been neglected as a possible confounder when comparing CTGNB to bronchoscopy.All patients with lung cancer histologically confirmed by bronchoscopy or CTGNB between 2010 and 2020 were enrolled and studied. Patients' medical histories, radiologic and pathologic findings and surgical records were reviewed. Pleural recurrence was diagnosed by pleural biopsy, fluid cytology, or by CT chest imaging showing progressive pleural nodules.In this retrospective unicenter analysis, 844 patients underwent curative resection for early-stage lung cancer between 2010 and 2020. Median follow-up was 47.5 months (3-137). 27 patients (3.2 %) with ipsilateral pleural recurrence (IPR) were identified. The distance of the tumor to the pleura was significantly smaller in patients who underwent CTGNB. A tendency of increased risk of IPR was observed in tumors located in the lower lobe (HR: 2.18 [±0.43], p = 0.068), but only microscopic pleural invasion was a significant independent predictive factor for increased risk of IPR (HR: 5.33 [± 0.51], p = 0.001) by multivariate cox analysis. Biopsy by CTGNB did not affect IPR (HR: 1.298 [± 0.39], p = 0.504).CTGNB is safe and not associated with an increased incidence of IPR in our cohort of patients. This observation remains to be validated in a larger multicenter patient cohort.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.