Needle biopsy can cause cancer cells to metastasize?

Needle biopsy can cause cancer cells to metastasize?  With the advancement of medical technology, the level of tumor detection is getting higher and higher. I believe that tumor puncture detection is gradually becoming familiar to patients, and tumor diagnosis will become more and more accurate.

In the diagnosis of clinical diseases, needle biopsy is a very important thing. For patients with malignant tumors, whether there are mutations in their pathological classification, typing and even genetic testing is the primary problem in the diagnosis and treatment of the disease, and the diagnosis directly determines the result. The use and efficacy of anti-tumor drugs. Therefore, needle biopsy has become an indispensable step in the process of disease diagnosis and treatment.

Let’s take a look at the possible complications of needle biopsy, and whether the needle biopsy that everyone has been paying attention to will cause metastasis and other related problems.

Question 1:

The patient’s CT examination found a pulmonary nodule 3.3 cm. The doctor suggested a needle biopsy. The Internet found that there were two methods of ultrasound and CT guidance. May I ask, which method is safer to choose?

Needle biopsy is a very important step in the treatment of tumors. The choice of methods or drug treatment for tumors often depends on the pathological results obtained from the needle biopsy. Clinically, needle biopsy is usually guided by ultrasound or CT to improve the success rate.

Ultrasound-guided needle biopsy is safe, fast, minimally invasive, effective, and reproducible. It can visualize blood vessels in real time and has multi-dimensional imaging capabilities. Especially for some tumors that are small and have unobvious morphological features, combined with color ultrasound Ultrasound-guided needle biopsy can greatly improve the early diagnosis rate of tumors, and has important guiding significance for early clinical prevention and treatment. Ultrasound-guided needle biopsy is widely used in superficial tumors, such as thyroid, breast tumors, lymph nodes, etc.; and abdominal organs, such as liver, kidney, pancreas, spleen, and abdominal masses.

CT guidance is mostly used for bony structures or lung diseases. In the lung and bone biopsy, because the lung has a high attenuation coefficient, and there is a certain acoustic impedance at the gas-soft tissue, gas-liquid plane, and bone interface, CT examination is better than ultrasound.

Based on your father’s situation, the editor recommends that you choose to perform a needle biopsy of the lesion under the guidance of CT. I wish all the best.

Question 2:

Will a puncture biopsy of a lung lesion guided by CT lead to the spread of tumor cells?

Your question is very good. Indeed, many patients in the clinic have such concerns, worrying that needle biopsy will pierce the tumor, and will it spread the tumor cells and cause it to metastasize? In fact, it is possible that part of the tumor tissue is obtained by puncture and aspiration. When the puncture needle is pulled out, a small amount of tumor cells may contaminate the original clean puncture needle channel, causing the tumor to be planted in the puncture needle channel, which is called medically. For planting transfer of puncture needles.

A large number of studies abroad have proved that the probability of metastasis caused by needle biopsy is minimal. Let’s first look at a set of data. The European Journal of Radiology published a large-sample, multi-center statistical data on CT-guided percutaneous lung biopsy. It shows that 6,881 patients with lung lesions underwent 9783 biopsy. , The number of patients with implant metastasis was 6 people. The probability of tumor implantation and metastasis caused by CT-guided percutaneous lung puncture: 6/6881, which is less than one in 1,000

The instruments used for puncture biopsy have also changed. The puncture needle used has a two-layer structure inside and outside. When taking the material, it is like a ballpoint pen. After the pen tip (needle tip) is attached to the tumor surface, press the switch to make the pen core inside penetrate the tumor. , The “pen core” will return to the shell of the ballpoint pen after the material is taken. This shell is a protective channel, so that during the process of pulling out the puncture needle, the leakage of tumor cells is avoided, and the human body is protected to the greatest extent. The professional and standardized puncture operation is designed to avoid the possibility of tumor implantation.

Based on the above points, the editor recommends that you and your family should actively cooperate with the doctor to perform a needle biopsy of the tumor lesion as soon as possible to obtain pathological and genetic test-related results as soon as possible, which has a guiding effect on subsequent treatment.

Question 3:

For lung nodules, the doctor recommends puncturing under CT guidance. What are the risks?

Puncture is a traumatic operation, and some complications may occur. The type and severity of the complications are related to the anatomical site of the biopsy. When choosing a needle biopsy, the doctor in charge will inform you in advance.

Lung puncture under CT guidance, because the puncture needle needs to pass through the skin and the retropleura through the lung tissue to reach the lesion. The lung tissue is the respiratory organ. When you inhale deeply, the lung tissue is like an inflated balloon. Once the needle is punctured If the pleura is broken, pneumothorax is prone to appear. This is the most common clinically. Under normal circumstances, lighter pneumothorax does not require special treatment, just need to take care of it, but if there is a more serious pneumothorax, it needs to be actively treated and drained in time.

In addition, after CT-guided lung puncture, patients may also experience hemoptysis and blood in sputum, but this situation will soon be relieved and no special treatment is required. If pain symptoms occur after puncture, analgesics can be given symptomatic treatment.

Question 4:

The patient’s history of non-small cell lung cancer has been 3 years, and the contralateral lung has been found to have metastasis. The doctor recommends another needle biopsy. Excuse me, does the pathological examination result during surgery have no guiding significance for the current treatment? Why do I need to puncture again?

Puncture is a traumatic operation, and some complications may occur. The type and severity of complications are related to the anatomical site of the biopsy. When choosing a needle biopsy, the doctor in charge will inform you in advance.

In the treatment of lung cancer patients, targeted therapy and immunotherapy are widely used, but after drug resistance, in order to guide the next treatment plan, it is often necessary to do 2 biopsy or even more biopsy. In particular, after the first generation of EGFR-TKI drug resistance, a variety of drug-resistant mutations such as T790M may occur, and even the transformation of small cell lung cancer may occur. These require another biopsy to determine.

Reasons for not re-testing the first tissue sample: Although the tissue sample can be stored for a long time after being fixed, the accuracy of the sample will deteriorate after a period of time, and the biopsy sample will be left after one test Very few, often fail to meet the criteria of the second test. At the same time, the purpose of a second biopsy is often to determine the resistance mechanism and the development of the disease. This information cannot be obtained in the first tissue sample, so a new biopsy is required.

Of course, not every patient has the opportunity to take a second biopsy. If tissue samples are not easy to obtain, they can also choose body fluid samples instead, such as: pleural fluid, ascites, pericardial effusion, blood samples, etc.

Based on your situation, new lesions have been found in the contralateral lung. If conditions permit, a needle biopsy is a good choice.

Summary

With the advancement of medical technology, the level of tumor detection is getting higher and higher. I believe that tumor puncture detection is gradually becoming familiar to patients, and I believe that tumor diagnosis will become more and more accurate.

(source:internet, reference only)

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