Rapid and Highly Sensitive Detection of Therapeutically Relevant Oncogenic Driver Mutations in EBUS-TBNA Specimens From Patients With Lung Adenocarcinoma

Oezkan, Filiz; Herold, Thomas; Darwiche, Kaid; Eberhardt, Wilfried; Worm, Karl; Christoph, Daniel C.; Wiesweg, Marcel; Freitag, Lutz; Schmid, K. W.; Theegarten, Dirk; Hager, Thomas; Koenig, Michael J.; He, Kai; Taube, Christian; Schüler, Martin; Breitenbuecher, Frank

doi:10.1016/j.cllc.2018.08.016

Cited by 11 publications

(13 citation statements)

References 27 publications

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“…A previous study by the same group, 28 primarily to assess methods of mutational analysis, also weighed EBUS samples, which were obtained with a 22G needle, without suction, using 2 or more passes. The samples were split: formalin‐fixed for pathological examination; and, for mutational analysis, freshly frozen in 1 mL of saline, then stored at −80°C.…”

Section: Discussionmentioning

confidence: 99%

Rapid onsite evaluation uses a very small proportion of total material aspirated at endobronchial or endoscopic ultrasound in the investigation of suspected thoracic malignancy

et al. 2021

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Introduction The objectives were: to measure the proportion of aspirated material used to make direct slides for rapid onsite evaluation (ROSE) at endobronchial (EBUS) and endoscopic ultrasound (EUS) in suspected thoracic malignancy; and to correlate pass weights with ROSE category and needle size. Method All EBUS and EUS cases for possible thoracic malignancy October 2018‐May 2019 were included. All material from each pass was expelled into a Petri dish. One drop of material was placed on each of two slides; one used for ROSE, the other fixed and remaining material processed to cell block. Dish and slides were weighed before and after this procedure on a sensitive balance and weight of aspirate and slide material calculated. When ROSE identified malignancy, slide production ceased but target sampling for ancillary studies continued. Results ROSE accuracy was 96.8%. Mean percentage by target of aspirated material used to make direct slides for ROSE was 1.9% in malignant cases and 3.6% in non‐malignant cases (P = .027 for difference). Mean percentage by pass was 5.9%. Mean weight of a single aspirate was 128.8 mg. Mean weight of aspirates insufficient on ROSE (175.7 mg) was significantly higher than the mean weight of benign or malignant aspirates (117.1 and 114.0 mg, respectively). Mean weight of aspirates using 22G needles (132.6 mg) was significantly higher than that for 25G needles (87.1 mg). Conclusion Material made into direct slides at EBUS and EUS and used in part for ROSE uses a tiny proportion of aspirated material with over 98% processed to cell block and available for ancillary testing in malignant cases.

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Section: Discussionmentioning

confidence: 99%

Rapid onsite evaluation uses a very small proportion of total material aspirated at endobronchial or endoscopic ultrasound in the investigation of suspected thoracic malignancy

et al. 2021

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“…Lung cancer is the leading cause of cancer-related mortality worldwide (25). Approximately 85% of cases are non-small cell lung cancer (NSCLC), and tissue analysis is key in the treatment of NSCLC (26,27). Many molecule inhibitors induce rapid and deep responses and confer superior disease control compared with standard platinum doublet chemotherapy (28)(29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

End-tidal capnographic monitoring during flexible bronchoscopy under fentanyl and midazolam sedation

Minami¹,

Murakami²,

Shibata³

et al. 2021

Ann Palliat Med

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Background: Bronchoscopic examination including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is well established for lung cancer diagnosis and staging. Sedation using fentanyl and midazolam is recommended during bronchoscopic examinations. Meanwhile, inadvertent oversedation is a clinical problem. The objective of this research was to estimate the frequency of apnea episodes by endtidal capnography under fentanyl and midazolam sedation during bronchoscopy.Methods: Eighty-five patients were enrolled retrospectively between August 2017 and March 2018 at Okayama Medical Center. Apnea was defined as the cessation of airflow for more than 10 seconds. We reviewed medical records, including capnographic data, by cap-ONE YG-227T (NIHON KOHDEN, Tokyo, Japan) during flexible bronchoscopy under fentanyl and midazolam sedation.Results: Patients received 49.4±20.6 µg of fentanyl [mean ± standard deviation (SD)] and 4.35±2.0 mg of midazolam (mean ± SD). The patients included 52 males and 33 females; the median age was 71 (range, 31-88) years were enrolled. Apnea episodes were recorded (median duration 18 seconds) in 85 patients (100%). Prolonged apnea episodes with more than 30 seconds occurred in 56 patients (65.8%). Furthermore, the median time was 32 (range, 5-102) seconds whose delay between the onset of an apnea episode and decline in the SpO 2 level of ≥4% from baseline.Conclusions: End-tidal capnography, cap-ONE YG-227T was effective for detecting the occurrence of apnea in patients undergoing a bronchoscopic examination under fentanyl and midazolam sedation.Monitoring might be useful for preventing inadvertent oversedation.

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“…In this study, TBLC was more likely to obtain fully adequate samples for NGS analysis than EBUS‐TBNA. Previous studies have reported the use of sample collection methods, which include pathological findings, molecular target tests, and NGS analysis, via EBUS‐TBNA for diagnosing lung cancer 15–18,23–26 . In these studies, about 82.8%–95.3% of EBUS‐TBNA samples were successfully utilized in NGS analysis 15–17 .…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported the use of sample collection methods, which include pathological findings, molecular target tests, and NGS analysis, via EBUS-TBNA for diagnosing lung cancer. [15][16][17][18][23][24][25][26] In these studies, about 82.8%-95.3% of EBUS-TBNA samples were successfully utilized in NGS analysis. [15][16][17] The current study obtained a similar result showing that the success rate of NGS analysis was 89.4% (fully adequate samples, 36.8%; partly adequate samples, 52.6%).…”

Section: Discussionmentioning

confidence: 99%

Comparison of adequacy between transbronchial lung cryobiopsy samples and endobronchial ultrasound‐guided transbronchial needle aspiration samples for next‐generation sequencing analysis

et al. 2020

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Background: Most lung cancer patients present with lesions in both lung fields and lymphadenopathy. Thus, transbronchial lung cryobiopsy (TBLC) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are commonly performed for diagnosing lung cancer. However, the adequacy of these samples for next-generation sequencing (NGS) analysis remains unclear. This study aimed to compare the adequacy between TBLC and EBUS-TBNA samples for NGS analysis. Methods: This retrospective cohort study included patients whose lung samples were collected via TBLC or EBUS-TBNA and analyzed using NGS. Out of 46 genes, the number of genes in TBNA and TBLC samples that could not be assessed via NGS analysis was mainly evaluated. Results: A total of 37 patients were included and classified into two groups (TBLC group, n = 18 and TBNA group, n = 19). The mean number of genes that could not be evaluated via NGS analysis was significantly lower in the TBLC group than in the TBNA group (0.9 vs. 10.3, P = 0.024). The median total area of tumor cells in TBLC samples was significantly greater than that in TBNA samples (6.3 [1.6-4.2] vs. 2.6 [0.2-17.3] mm 2 , P < 0.01). In the TBNA group, there were two fully inadequate samples for NGS analysis with a high degree of cell crush or low tumor content, while there was no fully inadequate sample in the TBLC group. Conclusions: TBLC is more effective in obtaining adequate samples for NGS analysis than EBUS-TBNA. TBLC should be performed to obtain adequate samples for NGS analysis in lung cancer patients with target lesions in lung fields, even if they have lymphadenopathy.

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Rapid and Highly Sensitive Detection of Therapeutically Relevant Oncogenic Driver Mutations in EBUS-TBNA Specimens From Patients With Lung Adenocarcinoma

Cited by 11 publications

References 27 publications

Rapid onsite evaluation uses a very small proportion of total material aspirated at endobronchial or endoscopic ultrasound in the investigation of suspected thoracic malignancy

Rapid onsite evaluation uses a very small proportion of total material aspirated at endobronchial or endoscopic ultrasound in the investigation of suspected thoracic malignancy

End-tidal capnographic monitoring during flexible bronchoscopy under fentanyl and midazolam sedation

Comparison of adequacy between transbronchial lung cryobiopsy samples and endobronchial ultrasound‐guided transbronchial needle aspiration samples for next‐generation sequencing analysis

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