DNA aneuploidy combined with radial EBUS in the diagnosis of peripheral lung lesions

Abstract

Objective: To explore the diagnostic value of DNA aneuploidy analysis combined with radial endobronchial ultrasound (R-EBUS)-guided transbronchial biopsy in peripheral lung lesions. Method:We performed a retrospective analysis of patients who underwent R-EBUS examination. DNA aneuploidy analysis of bronchial washing from the target bronchial segment were performed. The clinical information, R-EBUS data, pathological results and DNA image cytometry (DNA-ICM) results were collected. For patients who did not have a clear diagnosis after bronchoscopy, follow-up data was recorded.Results: A total of 42 cases were included. Thirty patients had confirmed malignant tumor of the lung, 19 of which were confirmed by pathology after bronchoscopy, and 11 cases were confirmed later by surgery or percutaneous lung puncture. Twelve patients were finally considered to have benign lesions. The sensitivity of R-EBUS is 63.3% and the specificity is 100%. DNA-ICM has a sensitivity of 76.7% and a specificity of 91.7%. When combined, they have a sensitivity of 90%, and specificity 91.7%. As for malignant lesions, we further analyzed smoking, the size and location of lesions on chest CT, the number of aneuploid cells and the maximum value of DNA content. The results indicated that increased number of aneuploid cells or increased max value of DNA content may predict higher probability of malignancy.Conclusion: DNA-ICM combined with R-EBUS can improve the diagnostic sensitivity of malignant peripheral lung lesions. Increased number of aneuploid cells or increased max value of DNA content may indicate that the lesions are more likely to be malignant.

DNA image cytometry of bronchial washing as a diagnostic adjunct to radial endobronchial ultrasound‐guided sampling of peripheral lung lesions: A single center prospective study

“… 13 Guo et al retrospectively explored the diagnostic value of DNA‐ICM combined with R‐EBUS‐guided sampling in 42 patients with PPLs and demonstrated a trend in increased sensitivity with the combined methods. 15 These preliminary studies showed promise for combining DNA‐ICM to increase the diagnostic yield of R‐EBUS‐guided sampling for PPLs, necessitating further prospective studies.…”

“…A previous study in our center by Hu et al combined DNA‐ICM with cytology in analysis of bronchial washings from 626 patients and found significantly increased sensitivity of the combined methods for diagnosis of lung cancer compared to cytology alone (75.8% vs. 53.3%, P < 0.05) 13 . Guo et al retrospectively explored the diagnostic value of DNA‐ICM combined with R‐EBUS‐guided sampling in 42 patients with PPLs and demonstrated a trend in increased sensitivity with the combined methods 15 . These preliminary studies showed promise for combining DNA‐ICM to increase the diagnostic yield of R‐EBUS‐guided sampling for PPLs, necessitating further prospective studies.…”

The Diagnostic Value of BRAF V600E Gene Detection Combined with DNA Ploidy Analysis in Thyroid Cancer

“…The emergence of DNA aneuploidy is usually a vital early step during carcinogenesis and constitutes a reliable marker of malignancy [23]. DNA ploidy analysis based on image cytometry results is very convenient, objective and possess a high accuracy in diagnosing several malignant cancer types, including oral and lung cancer [24,25]. DNA aneuploidy was reported to be closely related to thyroid epithelial lesions [26].…”