Izumo Takehiro, Matsumoto Yuji, Chavez Christine, Tsuchida Takaaki
Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, 5-1-1, Tsukiji Chou-ku, Tokyo, 104-0045, Japan.
BMC Pulm Med. 2016 Jul 26;16(1):106. doi: 10.1186/s12890-016-0268-3.
Re-biopsy for resistant non-small cell lung cancer (NSCLC) after treatment with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) is important for selection of better therapy, but there have been no reports about the utility of endobronchial ultrasound (EBUS)-guided procedures for such purpose. The aim of this study was to evaluate the utility of EBUS-guided re-biopsy for resistant NSCLC after treatment with EGFR-TKIs.
From January 2013 to December 2015, 53 consecutive patients who underwent EBUS-guided re-biopsy for mutation analysis of NSCLC after EGFR-TKI treatment were assessed.
Nine patients underwent EBUS-guided transbronchial needle aspiration (EBUS-TBNA) and 44 patients underwent EBUS with a guide sheath (EBUS-GS) transbronchial biopsy. The technical success rates were 100 %. As for mutation analysis, all 9 specimens (100 %) from EBUS-TBNA and 33 specimens (75.0 %) from EBUS-GS were adequate for gene profiling. The remaining 11 specimens from EBUS-GS procedures were inadequate for mutation analysis owing to the absence of tumor component in the sample (n = 6) or insufficient specimen (n = 5). There were no related severe complications.
Re-biopsy by both EBUS-TBNA and EBUS-GS were useful and safe sampling procedures for mutation analysis of EGFR-TKI resistant NSCLC.
表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗后对耐药性非小细胞肺癌（NSCLC）进行再次活检对于选择更好的治疗方法很重要，但尚无关于支气管内超声（EBUS）引导下的操作用于此目的的效用的报道。本研究的目的是评估EBUS引导下对EGFR-TKIs治疗后耐药的NSCLC进行再次活检的效用。
对2013年1月至2015年12月期间连续53例接受EGFR-TKI治疗后接受EBUS引导下再次活检以进行NSCLC突变分析的患者进行评估。
9例患者接受了EBUS引导下经支气管针吸活检（EBUS-TBNA），44例患者接受了带引导鞘的EBUS（EBUS-GS）经支气管活检。技术成功率为100%。关于突变分析，EBUS-TBNA的所有9个标本（100%）和EBUS-GS的33个标本（75.0%）足以进行基因分析。EBUS-GS操作的其余11个标本因样本中无肿瘤成分（n = 6）或标本不足（n = 5）而无法进行突变分析。没有相关的严重并发症。
EBUS-TBNA和EBUS-GS进行的再次活检都是用于EGFR-TKI耐药NSCLC突变分析的有用且安全的采样方法。
