Albert Sánchez-Font1,2,3, Roberto Chalela1,3, Clara Martín-Ontiyuelo1,3, Raquel Albero-González4, Alba Dalmases3,5, Raquel Longarón3,5, Virginia Alonso-Espinaco6, Víctor Curull1,2,3, Beatriz Bellosillo3,5, Lara Pijuan3,5. 1. Pulmonology Department, Hospital del Mar-Parc de Salut Mar, CIBER Respiratory Diseases, Carlos III Institute of Health, Barcelona, Spain. 2. Autonomous University of Barcelona, Barcelona, Spain. 3. Hospital del Mar Medical Research Institute, Barcelona, Spain. 4. Pathology Department, Hospital Universitari Mútua de Terrassa, Terrassa, Spain. 5. Pathology Department, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain. 6. Pompeu Fabra University, Barcelona, Spain.
Abstract
BACKGROUND: More than 60% of patients with lung cancer are diagnosed 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.
BACKGROUND: More than 60% of patients with lung cancer are diagnosed 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 ratsarcoma 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.
Authors: Catherine L Oberg; Ryan P Lau; Erik E Folch; Tao He; Reza Ronaghi; Irawan Susanto; Colleen Channick; Rodrigo Garcia Tome; Scott Oh Journal: Lung Date: 2022-10-10 Impact factor: 3.777
Authors: Nan Song; Li Yang; Hao Wang; Lei Jiang; Lishu Zhao; Sara Colella; Nikhil Jagan; Francisco A Almeida; Liang Wu; Ye Gu; Yayi He Journal: Transl Lung Cancer Res Date: 2021-06