TY - JOUR
T1 - Effect of smoking on the diagnostic results and complication rates of percutaneous transthoracic needle biopsy
AU - Lim, Woo Hyeon
AU - Lee, Jong Hyuk
AU - Park, Hyungin
AU - Park, Chang Min
AU - Yoon, Soon Ho
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/10
Y1 - 2024/10
N2 - Objective: To investigate the association of smoking with the outcomes of percutaneous transthoracic needle biopsy (PTNB). Methods: In total, 4668 PTNBs for pulmonary lesions were retrospectively identified. The associations of smoking status (never, former, current smokers) and smoking intensity (≤ 20, 21–40, > 40 pack-years) with diagnostic results (malignancy, non-diagnostic pathologies, and false-negative results in non-diagnostic pathologies) and complications (pneumothorax and hemoptysis) were assessed using multivariable logistic regression analysis. Results: Among the 4668 PTNBs (median age of the patients, 66 years [interquartile range, 58–74]; 2715 men), malignancies, non-diagnostic pathologies, and specific benign pathologies were identified in 3054 (65.4%), 1282 (27.5%), and 332 PTNBs (7.1%), respectively. False-negative results for malignancy occurred in 20.5% (236/1153) of non-diagnostic pathologies with decidable reference standards. Current smoking was associated with malignancy (adjusted odds ratio [OR], 1.31; 95% confidence interval [CI]: 1.02–1.69; p = 0.03) and false-negative results (OR, 2.64; 95% CI: 1.32–5.28; p = 0.006), while heavy smoking (> 40 pack-years) was associated with non-diagnostic pathologies (OR, 1.69; 95% CI: 1.19–2.40; p = 0.003) and false-negative results (OR, 2.12; 95% CI: 1.17–3.92; p = 0.02). Pneumothorax and hemoptysis occurred in 21.8% (1018/4668) and 10.6% (495/4668) of PTNBs, respectively. Heavy smoking was associated with pneumothorax (OR, 1.33; 95% CI: 1.01–1.74; p = 0.04), while heavy smoking (OR, 0.64; 95% CI: 0.40–0.99; p = 0.048) and current smoking (OR, 0.64; 95% CI: 0.42–0.96; p = 0.04) were inversely associated with hemoptysis. Conclusion: Smoking history was associated with the outcomes of PTNBs. Current and heavy smoking increased false-negative results and changed the complication rates of PTNBs. Clinical relevance statement: Smoking status and intensity were independently associated with the outcomes of PTNBs. Non-diagnostic pathologies should be interpreted cautiously in current or heavy smokers. A patient’s smoking history should be ascertained before PTNB to predict and manage complications. Key Points: • Smoking status and intensity might independently contribute to the diagnostic results and complications of PTNBs. • Current and heavy smoking (> 40 pack-years) were independently associated with the outcomes of PTNBs. • Operators need to recognize the association between smoking history and the outcomes of PTNBs.
AB - Objective: To investigate the association of smoking with the outcomes of percutaneous transthoracic needle biopsy (PTNB). Methods: In total, 4668 PTNBs for pulmonary lesions were retrospectively identified. The associations of smoking status (never, former, current smokers) and smoking intensity (≤ 20, 21–40, > 40 pack-years) with diagnostic results (malignancy, non-diagnostic pathologies, and false-negative results in non-diagnostic pathologies) and complications (pneumothorax and hemoptysis) were assessed using multivariable logistic regression analysis. Results: Among the 4668 PTNBs (median age of the patients, 66 years [interquartile range, 58–74]; 2715 men), malignancies, non-diagnostic pathologies, and specific benign pathologies were identified in 3054 (65.4%), 1282 (27.5%), and 332 PTNBs (7.1%), respectively. False-negative results for malignancy occurred in 20.5% (236/1153) of non-diagnostic pathologies with decidable reference standards. Current smoking was associated with malignancy (adjusted odds ratio [OR], 1.31; 95% confidence interval [CI]: 1.02–1.69; p = 0.03) and false-negative results (OR, 2.64; 95% CI: 1.32–5.28; p = 0.006), while heavy smoking (> 40 pack-years) was associated with non-diagnostic pathologies (OR, 1.69; 95% CI: 1.19–2.40; p = 0.003) and false-negative results (OR, 2.12; 95% CI: 1.17–3.92; p = 0.02). Pneumothorax and hemoptysis occurred in 21.8% (1018/4668) and 10.6% (495/4668) of PTNBs, respectively. Heavy smoking was associated with pneumothorax (OR, 1.33; 95% CI: 1.01–1.74; p = 0.04), while heavy smoking (OR, 0.64; 95% CI: 0.40–0.99; p = 0.048) and current smoking (OR, 0.64; 95% CI: 0.42–0.96; p = 0.04) were inversely associated with hemoptysis. Conclusion: Smoking history was associated with the outcomes of PTNBs. Current and heavy smoking increased false-negative results and changed the complication rates of PTNBs. Clinical relevance statement: Smoking status and intensity were independently associated with the outcomes of PTNBs. Non-diagnostic pathologies should be interpreted cautiously in current or heavy smokers. A patient’s smoking history should be ascertained before PTNB to predict and manage complications. Key Points: • Smoking status and intensity might independently contribute to the diagnostic results and complications of PTNBs. • Current and heavy smoking (> 40 pack-years) were independently associated with the outcomes of PTNBs. • Operators need to recognize the association between smoking history and the outcomes of PTNBs.
KW - Diagnosis
KW - Hemoptysis
KW - Image-guided biopsy
KW - Lung neoplasms
KW - Pneumothorax
UR - http://www.scopus.com/inward/record.url?scp=85188526156&partnerID=8YFLogxK
U2 - 10.1007/s00330-024-10705-8
DO - 10.1007/s00330-024-10705-8
M3 - Article
C2 - 38528137
AN - SCOPUS:85188526156
SN - 0938-7994
VL - 34
SP - 6514
EP - 6526
JO - European Radiology
JF - European Radiology
IS - 10
ER -