Molecular analysis of peripheral non‐squamous non‐small cell lung cancer sampled by radial <scp>EBUS</scp>

Guisier, Florian; Salaün, Mathieu; Lachkar, Samy; Lamy, Aude; Piton, Nicolas; Obstoy, Bérengère; Sabourin, Jean‐Christophe; Thiberville, Luc

doi:10.1111/resp.12737

Cited by 35 publications

(31 citation statements)

References 39 publications

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“…Guiser et al . demonstrated that the molecular diagnosis of R-EBUS specimens was feasible for approximately 80% of patients with peripheral lung cancer 23 . However, the majority of these specimens were biopsy, rather than bronchial brushing, specimens, and the results from EGFR mutation analyses of brushing specimens were not compared with those from patient-matched histological samples.…”

Section: Discussionmentioning

confidence: 99%

The value of radial endobronchial ultrasound-guided bronchial brushing in peripheral non-squamous non-small cell lung cancer

Tsai

et al. 2018

Sci Rep

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Radial endobronchial ultrasound (R-EBUS) is one important diagnostic approach in non-small cell lung cancers (NSCLC). However, the small samples obtained from R-EBUS-guided transbronchial biopsies are sometimes insufficient for pathological and molecular diagnosis. Herein, we investigated the suitability of R-EBUS-guided bronchial brushing specimens for NSCLC diagnosis and EGFR genotyping. We enrolled 941 consecutive patients with peripheral pulmonary lesions who underwent R-EBUS. Cytology-positive brushing specimens from non-squamous NSCLC patients were tested for EGFR mutations. Non-squamous NSCLC was diagnosed in 624 patients (66.3%). Positive cytology was documented in the brushing samples of 376 patients (60.3%). Higher diagnostic yields were obtained in patients exhibiting bronchus signs on chest tomography, and those with R-EBUS probe located within the lesion. EGFR genotyping was successfully performed in 363 samples (96.5% of cytology-positive brushing samples). EGFR genotyping concordance between brushing specimens and matched tissue samples was 88.7% (kappa = 0.745, P < 0.001). Furthermore, 144 non-squamous NSCLC patients (23.1%) with failed pathological diagnosis or EGER sequencing by R-EBUS-guided transbronchial biopsy required repeat biopsies. However, it was achieved successfully from the brushing specimens of 57 patients (39.6%). In conclusion, for patients with peripheral lung cancer, R-EBUS-guided bronchial brushing could provide an additional sampling method for diagnosis and EGFR genotyping.

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Section: Discussionmentioning

confidence: 99%

The value of radial endobronchial ultrasound-guided bronchial brushing in peripheral non-squamous non-small cell lung cancer

Tsai

et al. 2018

Sci Rep

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“…This biological context could inherently prevent the interference of nontumor cells in heterogeneous specimens and, therefore, explain the sensitivity of RT‐PCR–based systems in the analysis of oncogenic mutations even with traditional Sanger sequencing . In another study, Guisier et al could achieve the molecular analysis in 15 of 27 patients (55.6%) for whom brushing alone was positive for malignancy and in 12 of 15 patients (80%) for whom biopsies alone were positive for cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the diagnosis of peripheral pulmonary lesions (PPLs) is still a challenge in clinical practice because of the difficulty of approaching them with standard bronchoscopy and because of the need to obtain large samples for pathological and molecular diagnoses . R‐EBUS–guided transbronchial biopsy using fluoroscopy has proven to be the most effective noninvasive techniques for the pathological diagnosis of peripheral lung nodules, and the molecular profiling of these samples seems to be feasible when biopsy or cell blocks can be performed …”

Section: Introductionmentioning

confidence: 99%

Molecular analysis of peripheral lung adenocarcinoma in brush cytology obtained by EBUS plus fluoroscopy‐guided bronchoscopy

Sánchez-Font

Chalela

Martín-Ontiyuelo

et al. 2018

Cancer Cytopathology

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BACKGROUND: More than 60% of patients with lung cancer are diagnosesd at advanced stages. The introduction of targeted therapies requires molecular diagnosis to guide treatment. The aim of this study was to evaluate the feasibility of performing mutational analysis with brushing specimens obtained by radial-miniprobe endobronchial ultrasound (R-EBUS) plus fluoroscopy-guided bronchoscopy in patients with peripheral pulmonary adenocarcinoma. METHODS:Brushing specimens were deposited on cytological slides and were conserved in Roswell Park Memorial Institute (RPMI) culture medium. DNA was isolated to perform a mutational analysis with real-time quantitative polymerase chain reaction and Sanger sequencing for epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma viral oncogene homolog (KRAS). RESULTS: Thirty patients with adenocarcinoma were prospectively included. In 100% of the patients, the molecular study was viable with brushing specimens. In 16 (53.3%), KRAS or EGFR mutations were detected: 10 KRAS mutations (33.3%) and 6 EGFR mutations (20%). In a comparison with histological samples, a correlation of 86.6% was detected, and only 2 patients with wild-type results from brushing specimens presented with an EGFR mutation in histological samples. CONCLUSIONS: Brushing specimens conserved in RPMI medium and obtained by R-EBUS plus fluoroscopy-guided bronchoscopy are valid for molecular studies. They allow the detection of EGFR/KRAS mutations in patients with peripheral adenocarcinoma. In addition, invasive techniques are avoided, the risk of complications is reduced, and the obtained samples are optimized. Cancer Cytopathol 2018;126:860-871.

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“…Even though our numbers are small, this finding is comparable to a study by Guisier et al . where multi‐gene molecular analysis could be performed in 80% of pulmonary lesions sampled by radial‐EBUS . However, despite the favourable rate, the 20% insufficiency rate for mutational analysis in radial‐EBUS is still much higher than that of EBUS TBNA of mediastinal lesions which is 4% .…”

Section: Discussionmentioning

confidence: 99%

Radial‐probe endobronchial ultrasound outcomes in the investigation of peripheral pulmonary lesions: a New Zealand perspective

Good

Christensen

Herath

et al. 2018

Internal Medicine Journal

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Molecular analysis of peripheral non‐squamous non‐small cell lung cancer sampled by radial EBUS

Abstract: ABSTRACT

Cited by 35 publications

References 39 publications

The value of radial endobronchial ultrasound-guided bronchial brushing in peripheral non-squamous non-small cell lung cancer

The value of radial endobronchial ultrasound-guided bronchial brushing in peripheral non-squamous non-small cell lung cancer

Molecular analysis of peripheral lung adenocarcinoma in brush cytology obtained by EBUS plus fluoroscopy‐guided bronchoscopy

Radial‐probe endobronchial ultrasound outcomes in the investigation of peripheral pulmonary lesions: a New Zealand perspective

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