Ultrasound Guided Percutaneous Biopsy of Suspected Peripheral Lung Cancers: Impact of Present Smoking Trends

Abstract

Background: While CT guided tissue sampling is considered gold standard in almost all lung pathologies, US guided sampling can be performed in peripheral lung lesions abutting pleura making them ultrasonographically approachable with benefit of non-exposure to x-rays and contrast agents. Smoking is one of the common variables associated with lung malignancies and current study evaluates the impact of changing trends in smoking habits.
Aims/Objectives: To find the histopathological outcomes in patients of peripheral lung lesions and to describe the demographic variables and their association with malignant outcomes. Study Design: Retrospective study.
Material and Methods: Retrospective data from a total of 242 patients was collected who were subjected to US-guided biopsy of peripheral lung lesions measuring >2 cm using 18G biopsy needles. Demographic variables were inspected. Histopathological outcomes were categorised into benign and malignant with subcategorization.
Results: Benign pathology was found in 20.24% (n = 49) cases and malignant in 74.38% (n = 180). 75% (p-value = 0.03) of male and 73.52% (p-value=0.00) female smokers developed malignancy. Number of malignant cases increased with increased number of pack years among both genders (p-value = 0.028). Statistically significant difference was also found among males and females for cigarettes and tobacco consumption (p-value = 0.03 and 0.04 respectively) and alcohol consumption (p-value = 0.00) with malignant outcome. Squamous cell carcinoma was the most common malignant outcome with 39.6% cases, followed by adenocarcinoma (22.31%).
Conclusion: Ultrasound guided lung biopsy is effective and diagnostic for peripheral lung lesions of adequate sizes. The differences observed in exposure types and risk patterns suggest the need for targeted awareness and screening strategies.