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Conventional transbronchial needle aspiration is promising for identifying EGFR mutations in lung adenocarcinoma
BACKGROUND: Conventional transbronchial needle aspiration (TBNA) is advantageous for the one‐step diagnosis and staging of lung adenocarcinoma under topical anesthesia and conscious sedation. We examined its efficacy for identifying EGFR mutations. METHODS: Forty‐seven patients with proven or suspec...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons Australia, Ltd
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449271/ https://www.ncbi.nlm.nih.gov/pubmed/30810282 http://dx.doi.org/10.1111/1759-7714.13014 |
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author | Hsu, Li‐Han Ko, Jen‐Sheng Liu, Chia‐Chuan Feng, An‐Chen Chu, Nei‐Min |
author_facet | Hsu, Li‐Han Ko, Jen‐Sheng Liu, Chia‐Chuan Feng, An‐Chen Chu, Nei‐Min |
author_sort | Hsu, Li‐Han |
collection | PubMed |
description | BACKGROUND: Conventional transbronchial needle aspiration (TBNA) is advantageous for the one‐step diagnosis and staging of lung adenocarcinoma under topical anesthesia and conscious sedation. We examined its efficacy for identifying EGFR mutations. METHODS: Forty‐seven patients with proven or suspected lung adenocarcinoma indicated for hilar‐mediastinal lymph node (LN) staging between June 2011 and December 2017 were enrolled. The cellblock was prepared using the plasma‐thrombin method. TaqMan PCR was used to detect mutations. Considering cost effectiveness, only the sample with the highest tumor cell fraction in the same patient was chosen for analysis. RESULTS: TBNA provided positive results of malignancy in 27 patients. Seventeen patients (63.0%) had cellblocks eligible for mutation testing. Bronchial biopsy (n = 6), neck LN fine needle aspiration (n = 1), and brushing (n = 1), provided higher tumor cell fractions for analysis in eight patients. TBNA was the exclusive method used in nine patients (19.1%). For patients with an inadequate TBNA cellblock, bronchial biopsy (n = 5), neck LN fine needle aspiration (n = 3), computed tomography‐guided transthoracic needle biopsy (n = 1), and brushing (n = 1) were used for analysis. Modification to specimen processing to prevent exhaustion by cytology after June 2016 improved the adequacy of cellblock samples (9/10, 90% vs. 8/17, 47.1%; P = 0.042). CONCLUSIONS: These findings suggest the promising role of conventional TBNA and highlight the challenges of doing more with less in an era of precision medicine. |
format | Online Article Text |
id | pubmed-6449271 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley & Sons Australia, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-64492712019-04-15 Conventional transbronchial needle aspiration is promising for identifying EGFR mutations in lung adenocarcinoma Hsu, Li‐Han Ko, Jen‐Sheng Liu, Chia‐Chuan Feng, An‐Chen Chu, Nei‐Min Thorac Cancer Original Articles BACKGROUND: Conventional transbronchial needle aspiration (TBNA) is advantageous for the one‐step diagnosis and staging of lung adenocarcinoma under topical anesthesia and conscious sedation. We examined its efficacy for identifying EGFR mutations. METHODS: Forty‐seven patients with proven or suspected lung adenocarcinoma indicated for hilar‐mediastinal lymph node (LN) staging between June 2011 and December 2017 were enrolled. The cellblock was prepared using the plasma‐thrombin method. TaqMan PCR was used to detect mutations. Considering cost effectiveness, only the sample with the highest tumor cell fraction in the same patient was chosen for analysis. RESULTS: TBNA provided positive results of malignancy in 27 patients. Seventeen patients (63.0%) had cellblocks eligible for mutation testing. Bronchial biopsy (n = 6), neck LN fine needle aspiration (n = 1), and brushing (n = 1), provided higher tumor cell fractions for analysis in eight patients. TBNA was the exclusive method used in nine patients (19.1%). For patients with an inadequate TBNA cellblock, bronchial biopsy (n = 5), neck LN fine needle aspiration (n = 3), computed tomography‐guided transthoracic needle biopsy (n = 1), and brushing (n = 1) were used for analysis. Modification to specimen processing to prevent exhaustion by cytology after June 2016 improved the adequacy of cellblock samples (9/10, 90% vs. 8/17, 47.1%; P = 0.042). CONCLUSIONS: These findings suggest the promising role of conventional TBNA and highlight the challenges of doing more with less in an era of precision medicine. John Wiley & Sons Australia, Ltd 2019-02-27 2019-04 /pmc/articles/PMC6449271/ /pubmed/30810282 http://dx.doi.org/10.1111/1759-7714.13014 Text en © 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Hsu, Li‐Han Ko, Jen‐Sheng Liu, Chia‐Chuan Feng, An‐Chen Chu, Nei‐Min Conventional transbronchial needle aspiration is promising for identifying EGFR mutations in lung adenocarcinoma |
title | Conventional transbronchial needle aspiration is promising for identifying EGFR mutations in lung adenocarcinoma |
title_full | Conventional transbronchial needle aspiration is promising for identifying EGFR mutations in lung adenocarcinoma |
title_fullStr | Conventional transbronchial needle aspiration is promising for identifying EGFR mutations in lung adenocarcinoma |
title_full_unstemmed | Conventional transbronchial needle aspiration is promising for identifying EGFR mutations in lung adenocarcinoma |
title_short | Conventional transbronchial needle aspiration is promising for identifying EGFR mutations in lung adenocarcinoma |
title_sort | conventional transbronchial needle aspiration is promising for identifying egfr mutations in lung adenocarcinoma |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449271/ https://www.ncbi.nlm.nih.gov/pubmed/30810282 http://dx.doi.org/10.1111/1759-7714.13014 |
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