Adequacy of endobronchial ultrasound transbronchial needle aspiration samples in the subtyping of non-small cell lung cancer

Esterbrook, Georgina; Anathhanam, Sujo; Plant, Paul

doi:10.1016/j.lungcan.2012.12.017

Cited by 58 publications

(42 citation statements)

References 11 publications

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“…The total genotyping success rate for EGFR and ALK combined was higher still (99.0%). EGFR mutations were detected in 6.3% (5/80) patients with primary lung adenocarcinoma, a mutation prevalence rate which is comparable to results from two other UK studies (6% in both), which included non-squamous NSCLC and all NSCLC types, respectively (19,20). Ethnicity was not a significant factor in our study, although higher rates of EGFR mutation positivity (≤51.4%) have been described in Asian populations (34).…”

Section: Discussionsupporting

confidence: 85%

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Adequacy of endobronchial ultrasound-guided transbronchial needle aspiration samples processed as histopathological samples for genetic mutation analysis in lung adenocarcinoma

Jeyabalan

Bhatt

Plummeridge

et al. 2015

Molecular and Clinical Oncology

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Abstract. Phenotyping non-small-cell lung cancer is becoming increasingly important with the advent of molecular testing. Tumours harbouring somatic mutations in the gene that encodes for the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) have been found to increase responsiveness to tyrosine kinase inhibitors. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique for mediastinal node sampling. The available prospective data on EBUS-TBNA sample suitability for molecular profiling are currently limited. The aim of this prospective study was to evaluate the adequacy of EBUS-TBNA samples for EGFR and anaplastic lymphoma kinase (ALK) genetic mutation analysis in confirmed primary lung adenocarcinomas. We conducted a prospective analysis of 410 consecutive patients referred for EBUS-TBNA between 2010 and 2014. Rapid on-site cytological evaluation was not used. The samples were obtained using 21-gauge (21G) or 22G needles and were prepared as histopathological samples. A total of 91 samples were confirmed as lung adenocarcinomas and 80 of these samples were sent for EGFR mutation analysis. EBUS-TBNA had a diagnostic accuracy of 98.3% for malignancy. EGFR mutation testing was possible in 79/80 cases (98.75%). EGFR mutations were detected in 5/80 (6.3%) samples. ALK gene analysis, which became available during the study period, was requested and successfully performed in 21̸21 samples (100%). The total combined genotyping success rate was 100/101 (99.0%). This UK study confirmed the high clinical utility of EBUS-TBNA samples processed as histopathological specimens for EGFR and ALK genotyping in primary lung adenocarcinoma. The needle gauge did not affect genotyping efficacy.

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Section: Discussionsupporting

confidence: 85%

“…Several studies have investigated whether samples obtained during EBUS-TBNA are sufficient for molecular analysis and have demonstrated high, although variable, adequacy rates (77.7-98.7%) (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). These studies were heterogeneous in terms of cytohistopathological techniques and sample size.…”

Section: Introductionmentioning

confidence: 99%

Adequacy of endobronchial ultrasound-guided transbronchial needle aspiration samples processed as histopathological samples for genetic mutation analysis in lung adenocarcinoma

Jeyabalan

Bhatt

Plummeridge

et al. 2015

Molecular and Clinical Oncology

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“…In clinical practice, mediastinal lymph nodes were found to be involved in 28-38% NSCLC patients at the time of diagnosis (Silvestri et al, 2007). Previous reports indicate that EBUS-TBNA assessment of EGFR mutation is useful for patients with unresectable lung cancer in whom tissue specimens cannot be easily obtained (Neal et al, 2012;Esterbrook et al, 2013). However, we found that tumors metastasized to lymph nodes did not always show the same gene status as their primary compartments.…”

Section: Discussioncontrasting

confidence: 54%

Comparison of Epidermal Growth Factor Receptor Mutations between Primary Tumors and Lymph Nodes in Non-small Cell Lung Cancer: a Review and Meta-analysis of Published Data

Wang

Fang²,

Hou³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) can predict the clinical response to tyrosine kinase inhibitor (TKI) therapy. However, EGFR mutations may be different in primary tumors (PT) and metastatic lymph nodes (MLN). The aim of this study was to compare EGFR mutations between PT and the corresponding MLN in NSCLC patients, and provide some guidelines for clinical treatment using TKI therapy. Materials and Methods: A systematic review and meta-analysis was performed with several research databases. Relative risk (RR) with the 95% confidence interval (CI) were used to investigate the EGFR mutation status between PT and the corresponding MLN. A random-effects model was used. Results: 9 publications involving 707 patients were included in the analysis. It was found that activation of EGFR mutations identified in PT and the corresponding MLN was 26.4% (187/707) and 19.9% (141/707), respectively. The overall discordance rate in our meta-analysis was 12.2% (86/707). The relative risk (RR) for EGFR mutation in PT relative to MLN was 1.33 (95%CI: 1.10-1.60; random-effects model). There was no significant heterogeneity between the studies (I 2 =5%, p=0.003). Conclusions: There exists a considerable degree of EGFR mutation discrepancy in NSCLC between PT and corresponding MLN, suggesting that tumor heterogeneity might arise at the molecular level during the process of metastasis.

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“…However, according to our observations, as the pathology department gains more experience regarding the cytopathology of subtypes of lung cancer, the results should improve. Esterbrook et al [2] reported that EBUS-transbronchial needle aspiration (TBNA) samples, made into cell blocks and subjected to a panel of immunohistochemical stains, returned adequate tissue for cytological analysis in over 97% of cases. They also determined that cytology specimens are adequate for epidermal growth factor receptor (EGFR) mutation testing in over 88% of cases.…”

Section: Author's Replymentioning

confidence: 99%

“…Moreover, cytology alone is usually not sufficient for identifying these mutations. [2] A mediastinoscopy may be the best diagnostic method for patients with EGFR mutations since it provides a sufficient sample if the location of the LNs is accessible.…”

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confidence: 99%

Is the cytologic confirmation of malignancy sufficient for desicion making in treatmet of patients with non-small cell lung cancer?

Kavakli¹

2013

Turk Gogus Kalp Dama

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Adequacy of endobronchial ultrasound transbronchial needle aspiration samples in the subtyping of non-small cell lung cancer

Cited by 58 publications

References 11 publications

Adequacy of endobronchial ultrasound-guided transbronchial needle aspiration samples processed as histopathological samples for genetic mutation analysis in lung adenocarcinoma

Adequacy of endobronchial ultrasound-guided transbronchial needle aspiration samples processed as histopathological samples for genetic mutation analysis in lung adenocarcinoma

Comparison of Epidermal Growth Factor Receptor Mutations between Primary Tumors and Lymph Nodes in Non-small Cell Lung Cancer: a Review and Meta-analysis of Published Data

Is the cytologic confirmation of malignancy sufficient for desicion making in treatmet of patients with non-small cell lung cancer?

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