PMID- 23972930
OWN - NLM
STAT- MEDLINE
DCOM- 20131211
LR  - 20190221
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 96
IP  - 4
DP  - 2013 Oct
TI  - The efficacy of EBUS-guided transbronchial needle aspiration for molecular 
      testing in lung adenocarcinoma.
PG  - 1196-1202
LID - S0003-4975(13)01153-3 [pii]
LID - 10.1016/j.athoracsur.2013.05.066 [doi]
AB  - BACKGROUND: The purpose of the study was to assess the efficacy of obtaining 
      adequate cytologic specimens by endobronchial ultrasound-guided transbronchial 
      needle aspiration (EBUS-TBNA) for molecular testing of lung adenocarcinomas. 
      METHODS: This was an institutional review board-approved study of all patients 
      who had undergone EBUS-TBNA from April 2010 through March 2012 for the diagnosis, 
      staging, or both of lung cancer. Patients with a diagnosis of adenocarcinoma were 
      reflexively tested for molecular markers by polymerase chain reaction, 
      sequencing, and fluorescence in situ hybridization (FISH). All procedures were 
      performed with patients under conscious sedation in the bronchoscopy suite. 
      RESULTS: Of 205 patients who underwent EBUS-TBNA, 56 patients (24 male, 32 
      female) had a diagnosis of adenocarcinoma warranting molecular analysis. 
      Molecular analysis was available for epidermal growth factor receptor (EGFR), 
      Kirsten rat sarcoma (Kras) mutation, and anaplastic lymphoma kinase (ALK) gene 
      rearrangement. The institution's clinical protocol involved initial testing for 
      EGFR mutation with a reflex Kras test if the EGFR test result was negative. ALK 
      FISH molecular testing was completed if both EGFR and Kras test results were 
      negative. A total of 52 of 56 (93%) patients had sufficient cytologic material 
      for complete or partial molecular testing, whereas 46 of 56 (82%) patients had 
      sufficient material for all clinically indicated testing. EGFR, Kras, and ALK 
      analysis yielded positive results in 5 (10%), 10 (25%), and 5 (12%) tested 
      specimens, respectively. No complications were associated with EBUS-TBNA. 
      CONCLUSIONS: EBUS-TBNA performed with the patient under moderate sedation can be 
      expected to yield sufficient tissue for sequential molecular analysis in the 
      majority of patients. In an era of targeted therapy for lung adenocarcinomas, 
      EBUS-TBNA is effective in clinical practice for complete diagnosis, staging, and 
      treatment planning in these patients.
CI  - Copyright (c) 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Jurado, Julissa
AU  - Jurado J
AD  - Department of General Thoracic Surgery, Columbia University Medical Center, New 
      York, New York. Electronic address: jej2133@columbia.edu.
FAU - Saqi, Anjali
AU  - Saqi A
AD  - Department of Pathology and Cell Biology, Columbia University Medical Center, New 
      York, New York.
FAU - Maxfield, Roger
AU  - Maxfield R
AD  - Division of Pulmonary and Critical Care Medicine, Columbia University Medical 
      Center, New York, New York.
FAU - Newmark, Alexis
AU  - Newmark A
AD  - Department of General Thoracic Surgery, Columbia University Medical Center, New 
      York, New York.
FAU - Lavelle, Matt
AU  - Lavelle M
AD  - Department of General Thoracic Surgery, Columbia University Medical Center, New 
      York, New York.
FAU - Bacchetta, Matthew
AU  - Bacchetta M
AD  - Department of General Thoracic Surgery, Columbia University Medical Center, New 
      York, New York.
FAU - Gorenstein, Lyall
AU  - Gorenstein L
AD  - Department of General Thoracic Surgery, Columbia University Medical Center, New 
      York, New York.
FAU - Dovidio, Frank
AU  - Dovidio F
AD  - Department of General Thoracic Surgery, Columbia University Medical Center, New 
      York, New York.
FAU - Ginsburg, Mark E
AU  - Ginsburg ME
AD  - Department of General Thoracic Surgery, Columbia University Medical Center, New 
      York, New York.
FAU - Sonett, Joshua
AU  - Sonett J
AD  - Department of General Thoracic Surgery, Columbia University Medical Center, New 
      York, New York.
FAU - Bulman, William
AU  - Bulman W
AD  - Division of Pulmonary and Critical Care Medicine, Columbia University Medical 
      Center, New York, New York.
LA  - eng
PT  - Journal Article
DEP - 20130821
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adenocarcinoma/diagnosis/*pathology
MH  - Adenocarcinoma of Lung
MH  - Aged
MH  - Aged, 80 and over
MH  - *Endoscopic Ultrasound-Guided Fine Needle Aspiration
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/diagnosis/*pathology
MH  - Male
MH  - Middle Aged
MH  - Molecular Diagnostic Techniques
OTO - NOTNLM
OT  - 10
EDAT- 2013/08/27 06:00
MHDA- 2013/12/16 06:00
CRDT- 2013/08/27 06:00
PHST- 2012/11/10 00:00 [received]
PHST- 2013/05/17 00:00 [revised]
PHST- 2013/05/21 00:00 [accepted]
PHST- 2013/08/27 06:00 [entrez]
PHST- 2013/08/27 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - S0003-4975(13)01153-3 [pii]
AID - 10.1016/j.athoracsur.2013.05.066 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2013 Oct;96(4):1196-1202. doi: 10.1016/j.athoracsur.2013.05.066. 
      Epub 2013 Aug 21.