Optimising rapid on‐site evaluation‐assisted endobronchial ultrasound‐guided transbronchial needle aspiration of mediastinal lymph nodes: The real‐time cytopathology intervention process

Danakas, Alexandra; Jones, Carolyn E.; Magguilli, Michael; Lada, Michal J.; Plavnicky, John; Parajuli, Shobha; Wizorek, Joseph J.; Peyré, Christian G.; Ettel, Mark; Sweeney, Melissa; Casas, Luis E. De Las

doi:10.1111/cyt.12956

Cited by 5 publications

(1 citation statement)

References 15 publications

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“…If a diagnosis of lung cancer was established on-site, additional passes may have been requested to yield additional sample material for a predictive biomarker assessment [11,12].…”

Section: Performance Of Endobronchial Ultrasound-guided Transbronchial Needle Aspirationmentioning

confidence: 99%

Conventional Transbronchial Needle Aspiration (cTBNA) and EBUS-Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Retrospective Study on the Comparison of the Two Methods for Diagnostic Adequacy in Molecular Analysis

Signorini

Panozzi

Proietti

et al. 2021

JMP

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Introduction: In recent years, there has been a growing development of molecularly targeted therapies for various types of solid tumors—in particular, in non-small-cell lung cancer (NSCLC). This has required the need for greater quantities of tissue that is able to support ancillary studies, alongside cyto-histological diagnoses for the assessment of molecular targets. Conventional TBNA (cTBNA) and EBUS-guided TBNA (EBUS-TBNA) have shown a high diagnostic yield for malignant mediastinal and/or hilar lymph node enlargement and peribronchial masses; however, few studies have compared these two procedures. We retrospectively compared TBNA patients (EBUS-TBNA and cTBNA) in order to determine the diagnostic yield and material adequacy for subsequent ancillary analyses. Materials and Methods: We retrospectively evaluated 318 patients with clinical suspicion of lung cancer or with disease recurrence. All of the patients underwent TBNA (either EBUS-TBNA or cTBNA) on enlarged mediastinal and/or hilar lymph nodes and peribronchial masses between January 2017 and June 2021 at the University Hospital of Pisa, Italy. After a definitive diagnosis, molecular analyses and an evaluation of PD-L1 expression were performed in the cases of adenocarcinoma, squamous cell carcinoma, and NSCLC, not otherwise specified (NOS). Results: EBUS-TBNA was performed in 199 patients and cTBNA was performed in 119 patients with 374 and 142 lymph nodes, respectively. The overall diagnostic yield for positive diagnoses was 59% (diagnostic rate of 61% in EBUS-TBNA, and 55% in cTBNA). Adenocarcinoma (ADC) was the most frequent diagnosis in both methods. EBUS-TBNA diagnostic adequacy was 72% for molecular analysis, while it was 55.5% for cTBNA, showing a statistical trend (p = 0.08) towards the significance of EBUS. The average percentage of neoplastic cells was also statistically different between the two methods (p = 0.05), reaching 51.19 ± 22.14 in EBUS-TBNA and 45.25 ± 22.84 in cTBNA. With regard to the PD-L1 protein expression, the percentage of positivity was similar in both procedures (86% in EBUS-TBNA, 85% in cTBNA). Conclusions: Conventional TBNA (cTBNA) and EBUS-guided TBNA (EBUS-TBNA) are minimally invasive diagnostic methods that are associated with a high diagnostic yield. However, EBUS-TBNA has an improved diagnostic adequacy for molecular analysis compared to cTBNA, and is associated with a higher average percentage of neoplastic cells.

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“…If a diagnosis of lung cancer was established on-site, additional passes may have been requested to yield additional sample material for a predictive biomarker assessment [11,12].…”

Section: Performance Of Endobronchial Ultrasound-guided Transbronchial Needle Aspirationmentioning

confidence: 99%

Conventional Transbronchial Needle Aspiration (cTBNA) and EBUS-Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Retrospective Study on the Comparison of the Two Methods for Diagnostic Adequacy in Molecular Analysis

Signorini

Panozzi

Proietti

et al. 2021

JMP

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Lymph node evaluation and surgical procedure selection for non-small cell lung cancer

Zhaoming,

Zhenfa

2024

Holist Integ Oncol

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Lymph node metastasis is a common mode of metastasis in non-small cell lung cancer (NSCLC). Correct lymph node staging is crucial to the selection of treatment and the assessment of the prognosis of patients, and the selection of appropriate lymph node resection can prolong the survival of patients and reduce surgical trauma.In this review, the preoperative lymph node evaluation methods and the common intraoperative lymph node resection methods of NSCLC are reviewed, and the advantages and disadvantages of each method are compared. The purpose of this review is to summarize the latest research progress in the evaluation and resection of NSCLC lymph nodes, so as to select appropriate evaluation and resection methods in clinical work.

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Commentary: Leave the Knife and Take the Needle and a Cytopathologist

Reznik

2022

Seminars in Thoracic and Cardiovascular Surgery

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Optimising rapid on‐site evaluation‐assisted endobronchial ultrasound‐guided transbronchial needle aspiration of mediastinal lymph nodes: The real‐time cytopathology intervention process

Cited by 5 publications

References 15 publications

Conventional Transbronchial Needle Aspiration (cTBNA) and EBUS-Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Retrospective Study on the Comparison of the Two Methods for Diagnostic Adequacy in Molecular Analysis

Conventional Transbronchial Needle Aspiration (cTBNA) and EBUS-Guided Transbronchial Needle Aspiration (EBUS-TBNA): A Retrospective Study on the Comparison of the Two Methods for Diagnostic Adequacy in Molecular Analysis

Lymph node evaluation and surgical procedure selection for non-small cell lung cancer

Commentary: Leave the Knife and Take the Needle and a Cytopathologist

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