Chen Minjiang, Shao Chi, Xu Yan, Sun Xuefeng, Zhao Jing, Chen Yong, Zhao Yuanyuan, Zhong Wei, Wang Mengzhao
Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Zhongguo Fei Ai Za Zhi. 2018 Sep 20;21(9):670-676. doi: 10.3779/j.issn.1009-3419.2018.09.04.
Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has emerged as an innovative technique for diagnosis and staging of lung cancer. But whether the procedure can provide enough tissue for the detection of gene mutations is still to be defined. Here we evaluated the efficacy of lung cancer diagnosis and gene analysis using samples obtain via EBUS-TBNA.
Patients with suspected lung cancer and mediastinal lesions were referred for EBUS-TBNA. Diagnosis and sub-classifications were made by pathologists. Samples with non-squamous non small cell lung cancer sub type were tested for the EGFR and/or ALK mutations.
A total of 377 patients were included in this study. The median needle passes were 2.07. Lung cancer was diagnosed in 213 patients. The diagnosis accuracy for malignancy was 92%. Epidermal growth factor receptor (EGFR) mutations, anaplasticlymphoma kinase (ALK) fusion genes and double genes analysis were successfully preformed in 84 (90%), 105 (95%) and 79 (90%) patients. The number of needle passes and the diameters of lymph node were not associated with the efficacy of gene testing in univariate analysis. However, samples of adenocarcinoma sub type showed a tendency associated with higher genotyping efficacy.
Tissue samples obtained through EBUS-TBNA are sufficient for pathological diagnosis and genetic analysis of lung cancer. The pathology type of sample affected genotyping efficacy.
支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)已成为肺癌诊断和分期的一项创新技术。但该操作能否提供足够的组织用于检测基因突变仍有待确定。在此,我们评估了使用经EBUS-TBNA获取的样本进行肺癌诊断和基因分析的效果。
对疑似肺癌和纵隔病变的患者进行EBUS-TBNA。由病理学家进行诊断和亚分类。对非鳞状非小细胞肺癌亚型的样本检测表皮生长因子受体(EGFR)和/或间变性淋巴瘤激酶(ALK)突变。
本研究共纳入377例患者。穿刺针数中位数为2.07。213例患者被诊断为肺癌。恶性肿瘤的诊断准确率为92%。84例(90%)、105例(95%)和79例(90%)患者成功进行了表皮生长因子受体(EGFR)突变、间变性淋巴瘤激酶(ALK)融合基因及双基因分析。单因素分析中,穿刺针数和淋巴结直径与基因检测效果无关。然而,腺癌亚型样本显示出与更高基因分型效果相关的趋势。
通过EBUS-TBNA获取的组织样本足以用于肺癌的病理诊断和基因分析。样本的病理类型影响基因分型效果。