Analysis of risk of endobronchial biopsy-induced bleeding in different locations of lung cancer

Objective To investigate risk of endobronchial biopsy (EBB)-induced bleeding in different locations of lung cancer. Methods The clinical data of 643 patients diagnosed with lung cancer were collected from January 2014 to February 2018. The association of lesions of location with the risk of EBB-induced bleeding was evaluated using multivariate regression analysis adjusted for demographics, tumor characteristics, and comorbidities. Results After adjusting for sex, age, smoking history, pathological type and stage of tumor, complications [chronic obstructive pulmonary disease (COPD), hypertension, diabetes and coronary heart disease], platelet count, prothrombin time and activated partial thromboplastin time, multivariate regression analysis showed that compared to incidence of EBB-induced bleeding in right lower bronchus, the odds ratio (95% confidence interval) of left main bronchus, left upper bronchus, left lower bronchus, right main bronchus, right upper bronchus, right middle bronchus, right middle lobar bronchus and the trachea were 5.24(2.23, 12.31), 2.08(1.14, 3.80), 1.93(1.01, 3.67), 2.92(1.14, 7.47), 1.81(1.00, 3.30), 4.91(1.94, 12.45), 1.33(0.48, 3.63) and 2.19(0.58, 8.30). Conclusions Patients with lung cancer located in the central airways were more likely to bleed upon EBB when compared lesions located in the peripheral bronchi. Lesions located in left main bronchus, left upper bronchus were the most likely to bleed upon EBB among the central airways and peripheral bronchi, respectively. Key words: Lung neoplasms; Bronchoscopy; Biopsy; Hemorrhage