BACKGROUND: Endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA) of mediastinal lymph nodes is a minimally invasive and efficient tool for both diagnosis and staging of lung cancer. EBUS-FNA also permits tumor genotyping. However this critical datum for the therapeutic management is often long to obtain for metastatic patients with short life expectancy. METHODS: From May 2011 to December 2017, 398 lung cancer patients underwent a genetic analysis based on EBUS-FNA samples. EBUS-FNAs were performed with rapid on-site evaluation. Mutations were studied with Sanger or new generation sequencing. Forty-three cases were also tested with a fully automated real-time PCR rapid technique. ALK abnormalities were assessed by immunohistochemistry and/or in situ hybridization. RESULTS: A genotypic result could be obtained in 316 cases (79.4%) and in 180 of the 198 more recent cases (90.9%). Genetic abnormalities were observed in 191 cases (48.0%). Using the rapid technique, EGFR/KRAS mutational status was obtained within a few hours following the histological diagnosis and on the same day of the EBUS-FNA by analyzing fresh specimens after intra-operative cytological diagnosis. CONCLUSIONS: In term of molecular diagnosis, EBUS-FNA provides high-quality biological material similar to that of other clinical sampling methods. Furthermore, our study suggests that a rapid molecular diagnostic method could lead to a prompt and appropriate therapeutic management for many advanced stage patients.
BACKGROUND: Endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA) of mediastinal lymph nodes is a minimally invasive and efficient tool for both diagnosis and staging of lung cancer. EBUS-FNA also permits tumor genotyping. However this critical datum for the therapeutic management is often long to obtain for metastatic patients with short life expectancy. METHODS: From May 2011 to December 2017, 398 lung cancer patients underwent a genetic analysis based on EBUS-FNA samples. EBUS-FNAs were performed with rapid on-site evaluation. Mutations were studied with Sanger or new generation sequencing. Forty-three cases were also tested with a fully automated real-time PCR rapid technique. ALK abnormalities were assessed by immunohistochemistry and/or in situ hybridization. RESULTS: A genotypic result could be obtained in 316 cases (79.4%) and in 180 of the 198 more recent cases (90.9%). Genetic abnormalities were observed in 191 cases (48.0%). Using the rapid technique, EGFR/KRAS mutational status was obtained within a few hours following the histological diagnosis and on the same day of the EBUS-FNA by analyzing fresh specimens after intra-operative cytological diagnosis. CONCLUSIONS: In term of molecular diagnosis, EBUS-FNA provides high-quality biological material similar to that of other clinical sampling methods. Furthermore, our study suggests that a rapid molecular diagnostic method could lead to a prompt and appropriate therapeutic management for many advanced stage patients.
Authors: Deepali Jain; Timothy Craig Allen; Dara L Aisner; Mary Beth Beasley; Philip T Cagle; Vera Luiza Capelozzi; Lida P Hariri; Sylvie Lantuejoul; Ross Miller; Mari Mino-Kenudson; Sara E Monaco; Andre Moreira; Kirtee Raparia; Natasha Rekhtman; Anja Christiane Roden; Sinchita Roy-Chowdhuri; Gilda da Cunha Santos; Erik Thunnissen; Giancarlo Troncone; Marina Vivero Journal: Arch Pathol Lab Med Date: 2017-06-22 Impact factor: 5.534
Authors: Jordan P Reynolds; Raymond R Tubbs; Eugen C Minca; Stephen MacNamara; Francisco A Almeida; Patrick C Ma; Nathan A Pennell; Joseph C Cicenia Journal: Lung Cancer Date: 2014-09-22 Impact factor: 5.705
Authors: C Lim; M S Tsao; L W Le; F A Shepherd; R Feld; R L Burkes; G Liu; S Kamel-Reid; D Hwang; J Tanguay; G da Cunha Santos; N B Leighl Journal: Ann Oncol Date: 2015-04-28 Impact factor: 32.976
Authors: Vincent Thomas De Montpréville; Maria-Rosa Ghigna; Ludovic Lacroix; Antoinette Lemoine; Benjamin Besse; Olaf Mercier; Élie Fadel; Peter Dorfmuller; Thierry Le Chevalier Journal: Pathol Res Pract Date: 2017-03-30 Impact factor: 3.250
Authors: Niki Karachaliou; Clara Mayo; Carlota Costa; Ignacio Magrí; Ana Gimenez-Capitan; Miguel Angel Molina-Vila; Rafael Rosell Journal: Clin Lung Cancer Date: 2012-11-01 Impact factor: 4.785
Authors: Jérôme Solassol; Julie Vendrell; Bruno Märkl; Christian Haas; Beatriz Bellosillo; Clara Montagut; Matthew Smith; Brendan O'Sullivan; Nicky D'Haene; Marie Le Mercier; Morten Grauslund; Linea Cecilie Melchior; Emma Burt; Finbarr Cotter; Daniel Stieber; Fernando de Lander Schmitt; Valentina Motta; Calogero Lauricella; Richard Colling; Elizabeth Soilleux; Matteo Fassan; Claudia Mescoli; Christine Collin; Jean-Christophe Pagès; Peter Sillekens Journal: PLoS One Date: 2016-09-29 Impact factor: 3.240