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The associations of smoking status (never, former, current smokers) and smoking intensity (\u2264 20, 21\u201340, &gt; 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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among the 4668 PTNBs (median age of the patients, 66 years [interquartile range, 58\u201374]; 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\u20131.69; <jats:italic>p\u00a0<\/jats:italic>= 0.03) and false-negative results (OR, 2.64; 95% CI: 1.32\u20135.28; <jats:italic>p\u00a0<\/jats:italic>= 0.006), while heavy smoking (&gt; 40 pack-years) was associated with non-diagnostic pathologies (OR, 1.69; 95% CI: 1.19\u20132.40; <jats:italic>p\u00a0<\/jats:italic>= 0.003) and false-negative results (OR, 2.12; 95% CI: 1.17\u20133.92; <jats:italic>p\u00a0<\/jats:italic>= 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\u20131.74; <jats:italic>p\u00a0<\/jats:italic>= 0.04), while heavy smoking (OR, 0.64; 95% CI: 0.40\u20130.99; <jats:italic>p\u00a0<\/jats:italic>= 0.048) and current smoking (OR, 0.64; 95% CI: 0.42\u20130.96; <jats:italic>p\u00a0<\/jats:italic>= 0.04) were inversely associated with hemoptysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Smoking history was associated with the outcomes of PTNBs. Current and heavy smoking increased false-negative results and changed the complication rates of PTNBs.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical relevance statement<\/jats:title>\n                <jats:p>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\u2019s smoking history should be ascertained before PTNB to predict and manage complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:italic>\u2022 Smoking status and intensity might independently contribute to the diagnostic results and complications of PTNBs.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Current and heavy smoking (&gt; 40 pack-years) were independently associated with the outcomes of PTNBs.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Operators need to recognize the association between smoking history and the outcomes of PTNBs.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-024-10705-8","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T21:40:13Z","timestamp":1711402813000},"page":"6514-6526","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of smoking on the diagnostic results and complication rates of percutaneous transthoracic needle biopsy"],"prefix":"10.1007","volume":"34","author":[{"given":"Woo Hyeon","family":"Lim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Hyuk","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyungin","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang Min","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3700-0165","authenticated-orcid":false,"given":"Soon Ho","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"10705_CR1","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1183\/13993003.00359-2016","volume":"48","author":"J Malhotra","year":"2016","unstructured":"Malhotra J, Malvezzi M, Negri E, La Vecchia C, Boffetta P (2016) Risk factors for lung cancer worldwide. 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Soon Ho Yoon.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"Soon Ho Yoon has stocks and stock options in MEDICAL IP. The remaining authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The Medical Research Collaborating Center of Seoul National University Hospital (MRCC,\u00a0) reviewed statistical analyses of this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Data from some patients were previously reported, but none of those studies had an exact overlap with the study patients or focused on the association between smoking and PTNB.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}