Clinical And Animal Experiment Study Of The Effect Of Biopsy After Ablation On Pathological Results Of Lung Cancer

Objective:Lung cancer is one of the most common cancers worldwide with a high incidence and mortality rate.With the rapid development of targeted drugs,the identification of tumor histological types and genetic mutations has become a cornerstone of lung cancer treatment.Percutaneous ablation has the advantages of minimal trauma,low cost,simplicity and reproducibility.As a result,a growing number of scholars have proposed performing both lung biopsies and ablation during surgery.The aim of this study is to investigate whether biopsies performed immediately after ablation of lung malignancies affect the determination of pathological outcomes.Methods:This study retrospectively analyzed patients who underwent simultaneous lung ablation and needle biopsy from January 2019 to December 2021 at the Interventional Therapy Department of the First Hospital of China Medical University.Electronic medical records,imaging data,and pathology reports were used to obtain clinical information about the patients,including gender,age,procedure,ablation and biopsy sequence,and pathology diagnosis.Pathological diagnosis rates were compared between ablation and biopsy sequences,differences between different ablation methods,and factors affecting pathological diagnosis rates.Animal experiments were performed by constructing a subcutaneous tumor model in naked mice and including the tumor when its maximum diameter reached 1.0 cm.Tumor tissue was obtained by needle biopsy before and after ablation.HE staining and immunohistochemical staining were performed for pathology analysis.The SPSS 26.0 statistical software package was used for data processing analysis.The normally distributed measurement data were presented as mean± standard deviation.The count data were presented as the number of cases(percentage).The independent sample t test was used for the comparison of unpaired measurement data between groups.The paired sample t test was used for the comparison of paired measurement data.The level of significance of all tests was based on a two-sided P <0.05.Results:Sixty-nine patients who underwent intraprocedural percutaneous ablation and biopsy were divided into biopsy before ablation(n = 28),biopsy after microwave ablation(MWA,n = 21),and biopsy after cryoablation(CA,n = 20)groups,which had pathological diagnosis rates of 96.4%,85.7%,and 85.0%,respectively(P = 0.281).The Lesion type and diameter of the pulmonary nodules also had no significant effect on the pathological diagnosis rate.The only factor affecting the pathological diagnosis was insufficient sample size(P < 0.01).Animal experiments showed that CK7,P63,and TTF-1 expression in the biopsy sample was reduced after MWA(P = 0.025,P = 0.046,and P = 0.025,respectively),while no significant difference in immunohistochemical results was found before and after CA.Genetic testing results showed that all tissue samples after either MWA or CA had the EGFR mutation,which could be precisely mapped to the 19 DEL mutation.Conclusion:Needle biopsy immediately post-ablation was accurate and dependable for the pathological diagnosis of lung neoplasm.Samples obtained by this method could still be used for genetic testing.