Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, University of North Carolina in Chapel Hill, Chapel Hill, North Carolina.
Semin Respir Crit Care Med. 2013 Dec;34(6):787-91. doi: 10.1055/s-0033-1358555. Epub 2013 Nov 20.
The current management of non-small cell lung cancer (NSCLC) requires pathological differentiation between adenocarcinoma and squamous cell carcinoma using immunohistochemistry and morphological analysis. Additionally, as novel therapies for specific genetic mutation and chromosomal rearrangement profiles in patients with adenocarcinoma are becoming more numerous and clinically available, adequate tissue acquisition and specimen processing have become crucial. Historically, tissue was obtained via mediastinoscopy or video-assisted thoracoscopy (VATS). However, 80% of patients with lung cancer are ultimately found to be nonsurgical candidates. More recently, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been shown to be a safe and potentially superior modality to obtain tissue for diagnosis, staging, and molecular profiling. The preparation of tissue specimens has also been the subject of study as different methods have been shown to increase cellular yield. This is of particular importance as the number of clinically significant targetable mutations and chromosomal rearrangements continues to grow and the need for more tissue increases.
目前，非小细胞肺癌（NSCLC）的治疗需要通过免疫组织化学和形态分析对腺癌和鳞状细胞癌进行病理区分。此外，随着针对腺癌患者特定基因突变和染色体重排谱的新型治疗方法越来越多并在临床上可用，充分获取组织和处理标本变得至关重要。历史上，组织是通过纵隔镜或电视辅助胸腔镜（VATS）获得的。然而，80%的肺癌患者最终被认为不适合手术。最近，支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）已被证明是一种安全且潜在优越的获取组织进行诊断、分期和分子分析的方式。组织标本的制备也一直是研究的主题，因为不同的方法已被证明可以提高细胞产量。这一点尤其重要，因为具有临床意义的可靶向突变和染色体重排的数量不断增加，并且需要更多的组织。
