A Brief Retrospective Report on the Feasibility of Epidermal Growth Factor Receptor and KRAS Mutation Analysis in Transesophageal Ultrasound- and Endobronchial Ultrasound-Guided Fine Needle Cytological Aspirates

Schuurbiers, Olga C.J.; Looijen-Salamon, Monika; Ligtenberg, Marjolijn J. L.; Heijden, Erik H F M van der

doi:10.1097/jto.0b013e3181f0bd93

Cited by 109 publications

(78 citation statements)

References 19 publications

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“…Several studies have investigated whether samples obtained during EBUS-TBNA are sufficient for molecular analysis and have demonstrated high, although variable, adequacy rates (77.7-98.7%) (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). These studies were heterogeneous in terms of cytohistopathological techniques and sample size.…”

Section: Introductionmentioning

confidence: 99%

Adequacy of endobronchial ultrasound-guided transbronchial needle aspiration samples processed as histopathological samples for genetic mutation analysis in lung adenocarcinoma

Jeyabalan

Bhatt

Plummeridge

et al. 2015

Molecular and Clinical Oncology

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Abstract. Phenotyping non-small-cell lung cancer is becoming increasingly important with the advent of molecular testing. Tumours harbouring somatic mutations in the gene that encodes for the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) have been found to increase responsiveness to tyrosine kinase inhibitors. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique for mediastinal node sampling. The available prospective data on EBUS-TBNA sample suitability for molecular profiling are currently limited. The aim of this prospective study was to evaluate the adequacy of EBUS-TBNA samples for EGFR and anaplastic lymphoma kinase (ALK) genetic mutation analysis in confirmed primary lung adenocarcinomas. We conducted a prospective analysis of 410 consecutive patients referred for EBUS-TBNA between 2010 and 2014. Rapid on-site cytological evaluation was not used. The samples were obtained using 21-gauge (21G) or 22G needles and were prepared as histopathological samples. A total of 91 samples were confirmed as lung adenocarcinomas and 80 of these samples were sent for EGFR mutation analysis. EBUS-TBNA had a diagnostic accuracy of 98.3% for malignancy. EGFR mutation testing was possible in 79/80 cases (98.75%). EGFR mutations were detected in 5/80 (6.3%) samples. ALK gene analysis, which became available during the study period, was requested and successfully performed in 21̸21 samples (100%). The total combined genotyping success rate was 100/101 (99.0%). This UK study confirmed the high clinical utility of EBUS-TBNA samples processed as histopathological specimens for EGFR and ALK genotyping in primary lung adenocarcinoma. The needle gauge did not affect genotyping efficacy.

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Section: Introductionmentioning

confidence: 99%

Adequacy of endobronchial ultrasound-guided transbronchial needle aspiration samples processed as histopathological samples for genetic mutation analysis in lung adenocarcinoma

Jeyabalan

Bhatt

Plummeridge

et al. 2015

Molecular and Clinical Oncology

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“…One concern, however, is that there may be less tissue in an EBUS sample and that this could be insufficient to perform the required ancillary IHC and molecular testing. Current evidence from other studies suggests that EBUS-transbronchial needles aspiration (TBNA) samples are usually sufficient for molecular genetic testing with diagnostic rates between 72-95.5% (5)(6)(7)(8). Santis et al [2011] had a diagnostic rate of 95.5% with the aid of rapid on site examination (ROSE) (8).…”

Section: Introductionmentioning

confidence: 99%

Cell block samples from endobronchial ultrasound transbronchial needle aspiration provide sufficient material for ancillary testing in lung cancer—a quaternary referral centre experience

Hopkins¹,

Moffat²,

Parkinson³

et al. 2016

J. Thorac. Dis.

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Background: Rapid on site examination (ROSE) is encouraged at endobronchial ultrasound transbronchial needles aspiration (EBUS-TBNA) to improve diagnostic yield. Due to new therapeutic options in lung cancer, it is not sufficient to merely distinguish between non-small cell lung carcinoma (NSCLC) and small cell lung carcinoma (SCLC). Immunohistochemistry (IHC) distinction is now standard practice, as well as additional molecular testing where clinically indicated. We investigated the diagnostic yield of on-site smears vs. cell block and the provision of cellular material for ancillary testing at our centre.Methods: A retrospective audit of all EBUS-TBNA procedures performed until July 2012 was undertaken.Diagnostic yield on smears versus cell block was recorded. Cell blocks were reviewed by an experienced pathologist to determine diagnostic accuracy and whether IHC and molecular testing were possible. Results: In total, 234 procedures were recorded with 101 (43.2%) malignant cases, 107 (45.7%) benign cases and an initial 26/234 (11.1%) insufficient for diagnosis of which 11/234 (4.7%) were false negatives for malignancy after further follow up. The average number of passes was 4.5. For malignancies, smear diagnosis was possible in 95% (96/101) of cases and cell block diagnosis in 93.5% (87/93) of cases. There was sufficient material for IHC in 97.7% (85/87) of malignant cases. In 79.3% (69/87) of NSCLCs molecular testing for epidermal growth factor receptor (EGFR) mutation analysis was theoretically possible on samples obtained. Conclusions: Cell blocks are not inferior to smears for diagnostic accuracy and provide sufficient samples for histology. However, ROSE assists the physician on how best to manage samples for ancillary testing.

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“…It is commonly assumed that cytology cannot provide enough material to identify these mutations. Yet studies 22,[29][30][31] have demonstrated the utility of routine cytology specimens, such as brushes, washes, lavages, and FNA and EBUS material, as well as pleural and pericardial fluid in identifying mutations ( Table 2). The success rate of cytology material, however, does depend somewhat on the type of specimen.…”

Section: The Emerging Visibility Of the Pathologist And The Cytologismentioning

confidence: 99%

Lung Cancer in the Era of Targeted Therapy: A Cytologist's Perspective

Zakowski

2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.-The diagnosis and treatment of non-small cell lung cancer have changed dramatically in the past few years. The discovery of activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor and the use of drugs that successfully target those mutations are among the key advances that have led to a shift in the practice of oncology and pathology, with perhaps the greatest effect on the field of cytology.Objectives.-To present the perspective of a practicing thoracic pathologist and cytopathologist on the developments that have changed practice and to place those changes in a broader context. Data Sources.-Literature review, studies undertaken or participated in by the author, and personal experience.Conclusions.-Cytologists are in an ideal position to influence appropriate testing and treatment in the era of targeted therapy. Lung pathology has led the way in the era of targeted therapy, in no small part due to cytology.

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A Brief Retrospective Report on the Feasibility of Epidermal Growth Factor Receptor and KRAS Mutation Analysis in Transesophageal Ultrasound- and Endobronchial Ultrasound-Guided Fine Needle Cytological Aspirates

Abstract: Molecular analysis for KRAS and EGFR mutations can be performed routinely in cytologic specimens from EUS- and EBUS-guided FNA.

Cited by 109 publications

References 19 publications

Adequacy of endobronchial ultrasound-guided transbronchial needle aspiration samples processed as histopathological samples for genetic mutation analysis in lung adenocarcinoma

Adequacy of endobronchial ultrasound-guided transbronchial needle aspiration samples processed as histopathological samples for genetic mutation analysis in lung adenocarcinoma

Cell block samples from endobronchial ultrasound transbronchial needle aspiration provide sufficient material for ancillary testing in lung cancer—a quaternary referral centre experience

Lung Cancer in the Era of Targeted Therapy: A Cytologist's Perspective

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