支气管镜引导下超声内镜细针抽吸术用于非小细胞肺癌下一代测序的实用性：与其他支气管镜技术的比较。

Usefulness of endoscopic ultrasound with bronchoscope-guided fine-needle aspiration for next-generation sequencing in patients with non-small cell lung cancer: A comparison with other bronchoscopic techniques.

机构信息

Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kitatakamatsu-chou, Miyazaki-shi, Miyazaki, 880-8510, Japan.

出版信息

Respir Investig. 2024 Sep;62(5):879-883. doi: 10.1016/j.resinv.2024.07.012. Epub 2024 Aug 2.

DOI:10.1016/j.resinv.2024.07.012

PMID:39096541

Abstract

BACKGROUND

Next-generation sequencing (NGS) is essential in treating advanced lung cancer. However, the effectiveness of endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) in NGS remains unclear. This study examined the usefulness of EUS-B-FNA in lung cancer NGS cases where EUS-B-FNA was performed for specimen submission in a nationwide genomic screening platform (LC-SCRUM-Asia) and compared specimens collected using other bronchoscopy methods (endobronchial ultrasound-guided transbronchial needle aspiration [EBUS-TBNA] and EBUS-guided transbronchial biopsy with a guide sheath [EBUS-GS-TBB]) during the same period.

METHODS

We retrospectively compared the NGS success rates of NGS, DNA and RNA yields for EUS-B-FNA, EBUS-TBNA, and EBUS-GS-TBB from the records of the patients recruited for the Lung Cancer Genomic Screening Project for Individualized Medicine (LC-SCRUM)-Asia.

RESULTS

Fifty-one patients were enrolled, and the NGS success rates were comparable for samples obtained by EUS-B-FNA, EBUS-TBNA, and EBUS-GS-TBB (100%, 90.9%, and 81.0%, respectively). Genetic alterations were detected in 73.7%, 90.9%, and 85.7% of patients, respectively, with druggable genetic alterations found in 31.6%, 72.7%, and 61.9% of patients, respectively. The DNA and RNA yields were significantly higher in EUS-B-FNA samples than in EBUS-GS-TBB samples (50.4 (interquartile range (IR): 15.45-72.35) ng/μl and 33.9 (IR: 9-76.8) ng/μl from EUS-B-FNA, and 3.3 (IR: 1.4-7.1) ng/μl and 15.1 (IR: 8.3-31.5) ng/μl from EBUS-GS-TBB, respectively, p < 0.05).

CONCLUSION

EUS-B-FNA emerges as a promising bronchoscopic method for obtaining adequate samples for NGS in advanced lung cancer cases.

摘要

背景

下一代测序（NGS）在治疗晚期肺癌中至关重要。然而，支气管镜引导下超声内镜细针抽吸（EUS-B-FNA）在 NGS 中的有效性尚不清楚。本研究通过在全国性基因组筛查平台（LC-SCRUM-Asia）中进行标本提交的 EUS-B-FNA，检查了 EUS-B-FNA 在肺癌 NGS 病例中的有用性，并比较了同期使用其他支气管镜方法（支气管内超声引导经支气管针吸活检 [EBUS-TBNA] 和支气管内超声引导带鞘经支气管活检 [EBUS-GS-TBB]）获得的标本。

方法

我们回顾性比较了从参加肺癌个体化医学基因组筛查项目（LC-SCRUM-Asia）的患者记录中获得的 NGS、DNA 和 RNA 产量的 NGS 成功率，用于 EUS-B-FNA、EBUS-TBNA 和 EBUS-GS-TBB。

结果

共纳入 51 例患者，EUS-B-FNA、EBUS-TBNA 和 EBUS-GS-TBB 获得的样本 NGS 成功率相当（分别为 100%、90.9%和 81.0%）。分别有 73.7%、90.9%和 85.7%的患者检测到遗传改变，分别有 31.6%、72.7%和 61.9%的患者发现有可用药理遗传改变。EUS-B-FNA 样本的 DNA 和 RNA 产量明显高于 EBUS-GS-TBB 样本（EUS-B-FNA 为 50.4（四分位距（IR）：15.45-72.35）ng/μl 和 33.9（IR：9-76.8）ng/μl，EBUS-GS-TBB 为 3.3（IR：1.4-7.1）ng/μl 和 15.1（IR：8.3-31.5）ng/μl，p<0.05）。