PMID- 23312886
OWN - NLM
STAT- MEDLINE
DCOM- 20130830
LR  - 20181202
IS  - 1872-8332 (Electronic)
IS  - 0169-5002 (Linking)
VI  - 80
IP  - 1
DP  - 2013 Apr
TI  - Adequacy of endobronchial ultrasound transbronchial needle aspiration samples in 
      the subtyping of non-small cell lung cancer.
PG  - 30-4
LID - S0169-5002(12)00690-3 [pii]
LID - 10.1016/j.lungcan.2012.12.017 [doi]
AB  - INTRODUCTION: The histological subtyping of non small cell lung cancer (NSCLC) is 
      important in the selection of the optimal treatment for patients with advanced 
      disease. There are now important differences in the chemotherapy regimens used 
      for squamous and non-squamous cancers. Non-squamous cancers (particularly 
      adenocarcinomas) are also suitable for targeted therapy if the epidermal growth 
      factor receptor (EGFR) genetic mutation is present. Diagnosis is frequently made 
      by fine needle aspiration from lymph node metastases. We have evaluated the 
      adequacy of material obtained by EBUS-TBNA for subtyping of NSCLC. METHODS: All 
      EBUS-TBNA procedures performed at Leeds Teaching Hospitals between February 2009 
      and November 2011 were analysed. Data was collected on the indication, final 
      cytological diagnosis and whether EGFR mutation testing was possible. We analysed 
      the data to establish our rate of NSCLC-NOS diagnoses and to determine the 
      technical success of EGFR testing. RESULTS: Data from 391 procedures was 
      analysed. The indication was staging of malignancy in 345 patients and suspected 
      non-malignant disease in 48 patients. Malignant disease was diagnosed in 204 
      patients (53.7%), small cell 43, squamous cell 64, adenocarcinoma 40, 
      adenosquamous 2, large cell 12, NSCLC-NOS 31 and malignant disease of non-lung 
      primary 12. EBUS-TBNA identified 149 patients with NCSLC. Subtyping could be 
      obtained in 118 (79.2%). The number of patients with a diagnosis of NSCLC NOS on 
      EBUS-TBNA was 31 (20.8%, 95% CI 15-28%). Of the 204 specimens with a malignant 
      diagnosis immunohistochemistry was performed in 149 (73.0%). It was not performed 
      in 52 (25.5%) cases and there was insufficient material available in 3 (1.5%) 
      cases. EGFR testing was requested in 36 patients. Our test success rate for EGFR 
      mutation testing on EBUS-TBNA samples was 88.8% (95%CI 74.7-95.6%). CONCLUSION: 
      EBUS-TBNA samples when made into cell blocks and subjected to a panel of 
      immunohistochemical stains returned adequate tissue for cytological analysis in 
      over 97% of cases, with an NOS rate of 20.8%. We have also shown that cytology 
      specimens are adequate for EGFR mutation testing in over 88% of cases. We 
      conclude that EBUS-TBNA is an accurate diagnostic test both for determining NSCLC 
      subtype and performing EGFR mutation analysis to tailor treatment in lung cancer 
      patients.
CI  - Copyright (c) 2012 Elsevier Ireland Ltd. All rights reserved.
FAU - Esterbrook, Georgina
AU  - Esterbrook G
AD  - Department of Respiratory Medicine, Level 7, Gledhow Wing, St James's University 
      Hospital, Leeds, LS9 7TF, UK. georginaesterbrook@hotmail.com
FAU - Anathhanam, Sujo
AU  - Anathhanam S
FAU - Plant, Paul K
AU  - Plant PK
LA  - eng
PT  - Journal Article
DEP - 20130110
PL  - Ireland
TA  - Lung Cancer
JT  - Lung cancer (Amsterdam, Netherlands)
JID - 8800805
RN  - 0 (CD56 Antigen)
RN  - 0 (Chromogranins)
RN  - 0 (Keratin-5)
RN  - 0 (Keratin-6)
RN  - 0 (NCAM1 protein, human)
RN  - 0 (Nuclear Proteins)
RN  - 0 (TP63 protein, human)
RN  - 0 (Thyroid Nuclear Factor 1)
RN  - 0 (Transcription Factors)
RN  - 0 (Tumor Suppressor Proteins)
RN  - EC 2.7.10.1 (EGFR protein, human)
RN  - EC 2.7.10.1 (ErbB Receptors)
SB  - IM
MH  - CD56 Antigen/metabolism
MH  - Carcinoma, Non-Small-Cell Lung/classification/genetics/*pathology
MH  - Chromogranins/metabolism
MH  - DNA Mutational Analysis
MH  - Endoscopic Ultrasound-Guided Fine Needle Aspiration/*methods
MH  - ErbB Receptors/genetics
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - Keratin-5/metabolism
MH  - Keratin-6/metabolism
MH  - Lung/diagnostic imaging/metabolism/*pathology
MH  - Lung Neoplasms/classification/genetics/*pathology
MH  - Male
MH  - Mutation
MH  - Neoplasm Metastasis
MH  - Nuclear Proteins/metabolism
MH  - Reproducibility of Results
MH  - Thyroid Nuclear Factor 1
MH  - Transcription Factors/metabolism
MH  - Tumor Suppressor Proteins/metabolism
EDAT- 2013/01/15 06:00
MHDA- 2013/08/31 06:00
CRDT- 2013/01/15 06:00
PHST- 2012/07/24 00:00 [received]
PHST- 2012/12/12 00:00 [revised]
PHST- 2012/12/16 00:00 [accepted]
PHST- 2013/01/15 06:00 [entrez]
PHST- 2013/01/15 06:00 [pubmed]
PHST- 2013/08/31 06:00 [medline]
AID - S0169-5002(12)00690-3 [pii]
AID - 10.1016/j.lungcan.2012.12.017 [doi]
PST - ppublish
SO  - Lung Cancer. 2013 Apr;80(1):30-4. doi: 10.1016/j.lungcan.2012.12.017. Epub 2013 
      Jan 10.