Lung puncture biopsy is a commonly used diagnostic tool for lung cancer, mainly consisting of percutaneous needle aspiration (Fine needle aspiration ,FNA) and tissue excisional biopsy. The two methods are comparable in terms of diagnostic accuracy and incidence of adverse events; however, the latter allows more tissue specimens to be obtained for subsequent pathology and genetic testing.
Is it true that when a needle is inserted, the envelope of the lung cancer lesion is punctured, which may “bring out” the cancer cells and cause metastasis? In this article, we will talk about this topic.
“Puncture-induced lung cancer metastasis” is known professionally as “port-site metastasis (PSM),” also known as “needle tract tumor implantation metastasis. “This risk is not completely absent. This risk is not completely absent, but previous studies have confirmed that the probability is less than a few per thousand, which is a very low probability and rare event. In fact, even without puncture, tumor cells can be shed, and the reason they do not “take root” is that our immune system has some ability to clear them, and the environment is not suitable.
In addition, the tools used for lung puncture biopsy are being improved to avoid this as much as possible. Like the previous puncture needle, after the tissue specimen is taken, a small amount of tumor tissue adheres to the outer periphery of the needle and makes contact with normal tissue along the way, similar to a pencil going in and out. Today, the outer layer of the needle core comes with a protective cannula, and after cutting the tumor tissue, the cannula encloses the tumor tissue within the core, greatly reducing the chance of contact between the tumor tissue and normal tissue.
The biopsy gun reduces this risk even more. It resembles a shark with a neat, bloody mouth that bites the tissue off neatly and sharply. This approach is safer and the potential for puncture hole transfer is greatly reduced.
In conclusion, lung cancer metastasis from puncture is an extremely low probability event, and you have nothing to worry about.
Co-reviewed by: Guangdong Provincial People’s Hospital Guangdong Lung Cancer Institute Dr. Wang Zhen, deputy chief physician Dr. Linlin Lai