Search

Background: Lung cancer is often diagnosed at an advanced stage; however, it has shown improved therapeutic efficacy with the introduction of molecularly targeted drugs and immune checkpoint inhibitors, necessitating accurate molecular diagnosis for effective treatment planning. Traditional sampling techniques, including endobronchial ultrasound-guided transbronchial needle aspiration, frequently require multiple biopsies to obtain sufficient tissues for multiplex testing, highlighting the need for more efficient methods. Therefore, we explored the diagnostic utility of endoscopic ultrasound with bronchoscope-guided fine-needle biopsy (EUS-B-FNB) versus fine-needle aspiration (EUS-B-FNA) in patients with lung cancer, focusing on tissue sample collection for molecular testing. The introduction of the Franseen needle in EUS-B-FNB, characterized by three beveled edges, allows for more tissue collection in cylinder form., Methods: We retrospectively analyzed the data of 97 patients who underwent EUS-B-FNB or EUS-B-FNA at Hakodate Goryoukaku Hospital and evaluated diagnostic yields, safety, and nucleic acid concentrations using collected specimens., Results: The diagnostic yields of EUS-B-FNB and EUS-B-FNA were comparable (92.2% vs. 92.3%), with no significant differences in complications. However, EUS-B-FNB provided significantly higher DNA and RNA concentrations (DNA; 41.05 vs. 10.20 ng/mL; P < 0.0001, RNA; 36.80 vs. 11.80 ng/mL; P = 0.0009), essential for comprehensive molecular testing., Conclusion: This study highlights the potential of EUS-B-FNB for enhancing the molecular diagnosis of lung cancer by ensuring adequate tissue sample collection for multiplex testing, paving the way for personalized medicine. This technique is comparable in safety and efficacy to traditional methods while offering a substantial improvement in the quality of molecular diagnostics., Competing Interests: Declaration of competing interest Dr. Sumi received lecture fees from Ono Pharmaceutical, Nippon Boehringer Ingelheim, AstraZeneca and Sanofi outside of the submitted work. Dr. Ishigooka has no conflict of interest. Dr. Matsuura has no conflict of interest. Dr. Ikeda has no conflict of interest. Dr. Koshino has no conflict of interest. Dr. Suzuki has no conflict of interest. Dr. Arioka has no conflict of interest. Dr. Yamada has no conflict of interest. Dr. Chiba received a research grant from Nippon Boehringer Ingelheim outside of the submitted work. Dr. Chiba received lecture fees from Nippon Boehringer Ingelheim outside of the submitted work., (Copyright © 2024 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.)