Letter to the Editor
Core-Needle Biopsy in the Diagnosis of Lung Cancer
Biopsia con aguja gruesa en el diagnóstico de cáncer de pulmón
Jorge Lima Álvarez
, Alberto Beiztegui Sillero
Corresponding author
Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Sevilla, Spain
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Editor</span>" "titulo" => "Core-Needle Biopsy in the Diagnosis of Lung Cancer" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "654" "paginaFinal" => "655" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Jorge Lima Álvarez, Alberto Beiztegui Sillero" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Jorge" "apellidos" => "Lima Álvarez" "email" => array:1 [ 0 => "jorgelial@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Alberto" "apellidos" => "Beiztegui Sillero" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Sevilla, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Biopsia con aguja gruesa en el diagnóstico de cáncer de pulmón" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with great interest the SEPAR recommendations for the diagnosis and treatment of non-small cell lung cancer, published as a special issue in May 2016.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We found it well adapted to the needs of the pulmonologist today.</p><p id="par0015" class="elsevierStylePara elsevierViewall">However, in the subsection on minimally invasive techniques in the section dealing with cytohistological confirmation and staging studies, we were surprised to find that core needle biopsy (CNB) was not included among the techniques described.</p><p id="par0020" class="elsevierStylePara elsevierViewall">This is a very similar procedure to transthoracic fine needle aspiration biopsy (TFNAB). The same guidance techniques, generally computed tomography (CT) and sometimes the ultrasound, are used in both. The main difference between the two procedures is the caliber of the needle, generally 18G, which can yield specimens 1 or 2<span class="elsevierStyleHsp" style=""></span>cm thick, depending on the particular characteristics of the needle and the lesion. The caliber means that the needle track must always be anesthetized. The pulmonologists practicing in our hospital use both techniques. Capalbo et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> compared the two procedures in the diagnosis of pulmonary lesions, and reported a greater sensitivity for TFNAB (94.83%) compared to CNB (81.82%).</p><p id="par0025" class="elsevierStylePara elsevierViewall">As confirmed by the literature, this technique has been used for years in the diagnosis of lung cancer, with an acceptable rate of complications.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> The size of the specimen is greater than that obtained by the TFNAB, making it particularly suitable for studying genetic mutations in lung tumors, such as epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), among others. Although some centers are capable of performing these determinations from cytological samples, these laboratory techniques are not as widely implemented as studies performed on the histological sample, and as Schneider et al.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> demonstrated, CNB may be more cost-effective than TFNAB for the study of mutations.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In short, we believe that CNB should be included in paragraph 3.d on minimally invasive techniques of the SEPAR recommendations for the diagnosis and treatment of non-small cell lung cancer, along with bronchoscopy, blind transbronchial aspiration, endobronchial ultrasonography, gastrointestinal endoscopic ultrasonography, electromagnetic navigation bronchoscopy, fine needle aspiration biopsy, thoracentesis, pleural biopsy, and TFNAB, as another diagnostic procedure in non-small cell lung cancer.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Lima Álvarez J, Beiztegui Sillero A. Biopsia con aguja gruesa en el diagnóstico de cáncer de pulmón. Arch Bronconeumol. 2017;53:654–655.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[Article in English, Spanish]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recommendations of the Spanish Society of Pneumology and Thoracic Surgery on the diagnosis and treatment of non-small-cell lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.V. Álvarez" 1 => "I.M. Trueba" 2 => "J.B. Sanchis" 3 => "L.M. López-Rodó" 4 => "P.M. 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Ohori" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1309/AJCPMY8UI7WSFSYY" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Pathol" "fecha" => "2015" "volumen" => "143" "paginaInicial" => "193" "paginaFinal" => "200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25596245" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000011/v2_201711201359/S1579212917303002/v2_201711201359/en/main.assets" "Apartado" => array:4 [ "identificador" => "45358" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000011/v2_201711201359/S1579212917303002/v2_201711201359/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917303002?idApp=UINPBA00003Z" ]
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