Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Japan.
Department of General Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, Japan.
Jpn J Clin Oncol. 2024 Sep 4;54(9):1037-1044. doi: 10.1093/jjco/hyae077.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been used to diagnose and stage lung cancer. Acquire™ Pulmonary and Expect™ Pulmonary dedicated EBUS-TBNA needles were introduced as the Franseen and Lancet needles, respectively. It is still unclear whether the Franseen or Lancet needles yield a higher quality specimen especially focusing on next-generation sequencing-based molecular testing.
A single-center, prospective study performed at the Chiba University Hospital randomly assigned patients to two groups: Group A, wherein the first and second EBUS-TBNA were performed using Lancet and Franseen needles, respectively, and Group B, wherein the first and second EBUS-TBNA were performed using Franseen and Lancet needles, respectively. Each specimen was compared and analyzed pathologically. The primary outcome was the histological tissue area except blood clot and the cellularity of each sample. We also examined the success rate of molecular testing.
Twelve patients who underwent EBUS-TBNA between November 2022 and February 2023 were enrolled in this study. The tissue area of the specimens obtained by the Franseen and Lancet needles was 13.3 ± 6.4 mm2 and 10.6 ± 6.3 mm2, respectively (P = .355). The tumor cellularity in the specimens obtained using the Franseen and Lancet needles was 54.0 ± 30.3 and 46.2 ± 36.3%, respectively (P = .608). The success rate of molecular testing using the single-pass sample by Franseen needle was 85.7 and 57.1% by Lancet needle. No serious complications were reported.
The Franseen needle tended to show a greater amount of specimen with higher tumor cellularity than the Lancet needle which may contribute higher success rate of molecular testing. Further studies must be conducted to validate the results of this study.
What is known and what is new? What is the implication, and what should change now?
支气管内超声引导经支气管针吸活检术（EBUS-TBNA）已被用于诊断和分期肺癌。Acquire™ 肺部和 Expect™ 肺部专用 EBUS-TBNA 针分别作为 Franseen 和 Lancet 针引入。目前尚不清楚分别使用 Franseen 和 Lancet 针进行第一次和第二次 EBUS-TBNA 是否会获得更高质量的标本，特别是在基于下一代测序的分子检测方面。
本研究在千叶大学医院进行了一项单中心前瞻性研究，将患者随机分配到两组：A 组，第一次和第二次 EBUS-TBNA 分别使用 Lancet 和 Franseen 针进行；B 组，第一次和第二次 EBUS-TBNA 分别使用 Franseen 和 Lancet 针进行。比较和分析了每个标本的病理结果。主要结局是每个样本的除血栓外的组织面积和细胞数。我们还检查了分子检测的成功率。
2022 年 11 月至 2023 年 2 月期间进行 EBUS-TBNA 的 12 名患者被纳入本研究。使用 Franseen 和 Lancet 针获得的标本的组织面积分别为 13.3 ± 6.4 mm2 和 10.6 ± 6.3 mm2（P =.355）。使用 Franseen 和 Lancet 针获得的标本中的肿瘤细胞数分别为 54.0 ± 30.3 和 46.2 ± 36.3%（P =.608）。使用单通法的 Franseen 针进行分子检测的成功率为 85.7%，而使用 Lancet 针的成功率为 57.1%。未报告严重并发症。
Fransen 针的标本量比 Lancet 针大，肿瘤细胞数也更高，这可能有助于提高分子检测的成功率。需要进一步的研究来验证本研究的结果。
已知和未知的是什么？这意味着什么，现在应该改变什么？
