Prospective evaluation of EBUS-TBNA specimens for programmed death-ligand 1 expression in non-small cell lung cancer patients: a pilot study

Abstract

Objective: EBUS-TBNA cytological sampling is routinely performed for pathological diagnosis, mediastinal staging, and molecular testing in lung cancer patients. EBUS-TBNA samples are not formally accepted for testing programmed death-ligand 1 (PD-L1) expression. The objective of the study was to compare the feasibility, reproducibility, and accuracy of PD-L1 expression assessment in cytological specimens and histological samples. Methods: We prospectively collected histological (transbronchial forceps biopsy) and cytological (EBUS-TBNA) samples from peribronchial neoplastic lesions during an endoscopic procedure at the same target lesion for the pathological diagnosis and molecular assessment of stage IV non-small cell lung cancer (NSCLC). Results: Fifteen patients underwent the procedure. Adequate cytological samples (at least 100 neoplastic cells) were obtained in 12 cases (92.3%). Assessment of PD-L1 expression was similar between histological and cytological samples (agreement rate = 92%). Sensitivity and diagnostic accuracy of EBUS-TBNA cytological specimens were 88.9% and 100%, respectively. Conclusions: The evaluation of PD-L1 expression in EBUS-TBNA cytological specimens is feasible and presents good reproducibility when compared with routine histological samples. EBUS-TBNA cytological samples could be used for the assessment of PD-L1 expression in patients with NSCLC as a minimally invasive approach in stage IV NSCLC cancer patients.

In EBUS Signo Vinces: New Indications in Thoracic Oncology for Mediastinal Lymph Node Staging Using Endobronchial Ultrasound

“…EBUS-TBNA cytologic specimens have been effectively used to assess a variety of molecular targets, including EGFR, Anaplastic Lymphoma Kinase (ALK), and c-ros oncogene 1 (ROS-1). They are acceptable and equivalent to histologic samples for assessing target markers (20).…”

“…EBUS specimens can be obtained from a single procedure for pathological diagnosis, staging, and comprehensive molecular assessment, thereby establishing the foundation for the personalised therapy era, which combines minimally invasive procedures with biological agents to achieve the best oncological outcomes. EBUS-TBNA represents the best diagnostic approach in many different clinical scenarios in high-volume thoracic oncology centres and is valid and accurate in underpinning modern oncological therapy, guiding the best and tailored treatment options in lung cancer (20).…”

Effector Memory T Cells and CD45RO+ Regulatory T Cells in Metastatic vs. Non-Metastatic Lymph Nodes in Lung Cancer Patients

“…It is known that tests performed with the use of peripheral blood (PB) do not show local changes in lung cancer microenvironment. PB serves as a material for the assessment of systemic changes while EBUS/TBNA node biopsy is the material that allows to obtain rich cellular material from the nearest disease area reflecting the tumor microenvironment (TME) ( 7 ).…”