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Adequacy of Lymph Node Transbronchial Needle Aspirates Using Convex Probe Endobronchial Ultrasound for Multiple Tumor Genotyping Techniques in Non–Small-Cell Lung Cancer
- Source :
- Journal of Thoracic Oncology. 8:1438-1444
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- Introduction Adequate tumor acquisition is essential to identify somatic molecular alterations in non–small-cell lung cancer (NSCLC), such as epidermal growth factor receptor ( EGFR ) mutations and anaplastic lymphoma kinase ( ALK ) translocations. The success and failure rates for tumor genotyping of tissue obtained from fine-needle aspirates of nodal tissue using a convex probe endobronchial ultrasound (CP-EBUS) and other diagnostic modalities in routine NSCLC care have not been described. Methods Clinicopathologic data, tumor genotype success and failure rates were retrospectively compiled and analyzed from 207 patient-tumor samples sent for routine tumor genotype in clinical practice, including 42 patient-tumor samples obtained from hilar or mediastinal lymph nodes using CP-EBUS. Results The median age of the patients was 65 years, 62.3% were women, 77.8% were white, 26.6% were never smokers, 73.9% had advanced NSCLC, and 84.1% had adenocarcinoma histology. Tumor tissue was obtained from CP-EBUS–derived hilar or mediastinal nodes in 42 cases (20.2% of total). In this latter cohort, the overall success rate for EGFR mutation analysis was 95.2%, for Kirsten rat sarcoma viral oncogene homolog ( KRAS ) mutation 90.5%, and for ALK fluorescence in situ hybridization 90.5%. In the complete 207 tumors, the success rate for EGFR was 92.3%, for KRAS 91.8%, and for ALK 89.9%. The failure rates were not significantly different when comparing CP-EBUS–derived nodal tissue versus all other samples or versus surgical biopsies of mediastinal nodes, but were significantly lower than image-guided percutaneous transthoracic core-needle biopsies. Conclusions The success rate of multiple tumor genomic analyses techniques for EGFR , KRAS , and ALK gene abnormalities using routine lung cancer tissue samples obtained from hilar or mediastinal lymph nodes by means of CP-EBUS exceeds 90%, and this method of tissue acquisition is not inferior to other specimen types. Tumor genotype techniques are feasible in most CP-EBUS–derived samples and therefore further expansion of routine tumor genotype for the care of patients with NSCLC may be possible using targeted sample acquisition through CP-EBUS.
- Subjects :
- Male
Pathology
Lung Neoplasms
Transbronchial needle aspiration
Failure
medicine.disease_cause
Polymerase Chain Reaction
Endosonography
Mediastinoscopy
Anaplastic lymphoma kinase
Core biopsy
Carcinoma, Non-Small-Cell Lung
Computed tomography
Lymph node
Aged, 80 and over
Bone specimen
medicine.diagnostic_test
Middle Aged
Tumor genotype
Prognosis
ErbB Receptors
medicine.anatomical_structure
Oncology
Carcinoma, Squamous Cell
Adenocarcinoma
Female
KRAS
Lung cancer
Endobronchial ultrasound
Adult
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Genotype
Biopsy, Fine-Needle
Kirsten rat sarcoma viral oncogene homolog
Bronchi
Molecular testing
Article
Proto-Oncogene Proteins p21(ras)
Proto-Oncogene Proteins
Biopsy
Carcinoma
medicine
Humans
Aged
Neoplasm Staging
Retrospective Studies
Epidermal growth factor receptor
business.industry
Non–small-cell lung cancer
Never smokers
medicine.disease
Mutation
ras Proteins
Lymph Nodes
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15560864
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Journal of Thoracic Oncology
- Accession number :
- edsair.doi.dedup.....b8bc256b53ada409c38bb195b743f8a5