Cryobiopsy with endobronchial ultrasonography using a guide sheath for peripheral pulmonary lesions and DNA analysis by next generation sequencing and rapid on-site evaluation

Arimura, Ken; Tagaya, Etsuko; Akagawa, Hiroyuki; Nagashima, Yoji; Shimizu, Satoru; Atsumi, Yoshihide; Sato, Akitoshi; Kanzaki, Masato; Kondo, Mitsuko; Takamatsu, Kiyoshi; Massion, Pierre P.; Tamaoki, Jun

doi:10.1016/j.resinv.2018.10.006

Cited by 42 publications

(67 citation statements)

References 31 publications

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“…showed that gene analysis and whole genome sequencing is possible on cryobiopsy samples and supposed an advantage compared to forceps biopsy [54,55]. Naito et al measured a larger amount of DNA in cryobiopsies compared to forceps biopsies resulting in more successful whole-exome sequencing.…”

Section: Discussionmentioning

confidence: 99%

Cryobiopsy increases the EGFR detection rate in non-small cell lung cancer

et al. 2020

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A B S T R A C TObjectives: Detection of activating epidermal growth factor receptor (EGFR) mutation is crucial for individualized treatment of advanced non-small-cell lung cancer (NSCLC). However little is known about how biopsy technique affects the detection rate of EGFR mutations. This retrospective, single center study evaluated the detection rate of EGFR mutations in tissue obtained by bronchoscopic cryobiopsy and compared this to other standard tissue sampling techniques. Materials and methods: We retrospectively analyzed 414 patients with histologically confirmed NSCLC and known EGFR mutation status between 3/2008-7/2014. Tumor specimens obtained by tissue preserving bronchoscopic cryobiopsy were compared to those obtained by other techniques. Results and conclusion: Analysis of bronchoscopic cryobiopsy tissue detected 29 activating EGFR mutations in 27 (21.6 %) out of 125 patients, while analysis of tissue obtained by non-cryobiopsy techniques (bronchoscopic forceps biopsies, fine needle aspiration, imaging guided transthoracical and surgical procedures) detected 42 EGFR mutations in 40 (13.8 %) out of 298 patients (p < 0.05). Cryobiopsy increased detection rate of EGFR mutations in central tumors compared with forceps biopsy (19.6 % versus 6.5 %, p < 0.05), while an insignificant trend was detected also for peripheral tumors (33.3 % versus 26.9 %).Bronchosopic cryobiopsy increases the detection rate of activating EGFR mutations in NSCLC in comparison to other tissue sampling techniques. This will help to optimize individualized treatment of patients with advanced tumors. Because of the retrospective nature of this analysis, a prospective trial is mandatory for final assessment.

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Section: Discussionmentioning

confidence: 99%

Cryobiopsy increases the EGFR detection rate in non-small cell lung cancer

et al. 2020

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“…Accordingly, we anticipated that it would be useful for the immunohistochemical and molecular analysis of peripheral pulmonary lesions (PPLs), which are common in NSCLC. However, reports on the use and safety of this technique for the diagnosis of PPLs are few [15,16,17,18]. Furthermore, the collection of multiple samples via CB, which is not possible with FB, can present high risks and may be technologically difficult.…”

Section: Introductionmentioning

confidence: 99%

Safety and Usefulness of Cryobiopsy and Stamp Cytology for the Diagnosis of Peripheral Pulmonary Lesions

Imabayashi

Uchino

Yoshimura

et al. 2019

Cancers

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Reports on the use of cryobiopsy (CB) for lung cancer diagnosis are limited. The aims of the present study were to evaluate the safety and usefulness of CB using radial endobronchial ultrasonography, without a guide sheath, for the diagnosis of peripheral pulmonary lesions and determine the utility of stamp cytology, an on-site diagnostic technique for determining tumor inclusion in CB samples. We retrospectively analyzed data for 35 patients (36 lesions) with suspected peripheral lung cancer who underwent CB between August 2017 and February 2019 at our medical facility. The diagnostic yield, incidence of complications, and the utility of stamp cytology for diagnosis were investigated. The diagnostic yield of CB was 86.1% (31/36) with histological diagnosis, and 80.5% (29/36) with diagnosis using stamp cytology; the overall yield was 91.6% (33/36). Pneumothorax requiring thoracic drainage occurred in two patients, both of whom had lesions contacting the pleura. Grade 2 and grade 1 bleeding occurred in one and 25 patients, respectively. CB enables the collection of very large, nearly intact tissue samples, thus resulting in an improvement in the true diagnosis rate and facilitating the measurement of multiple biomarkers as well as rapid histological diagnosis.

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“…Therefore, cryobiopsy (Cryo) with EBUS-GS may be a useful tool for overcoming this problem. Cryo with EBUS-GS has been shown to be a safe and useful tool for PPLs suspicious of lung cancer [14, 15]. We previously reported that Cryo with EBUS-GS yields significantly larger tissues than TBB and provides high quantity and quality DNA for gene analysis by next generation sequencing.…”

Section: Introductionmentioning

confidence: 99%

“…We previously reported that Cryo with EBUS-GS yields significantly larger tissues than TBB and provides high quantity and quality DNA for gene analysis by next generation sequencing. Furthermore, Cryo with EBUS-GS provides a high concordance between rapid on-site evaluation and the final diagnosis [14]. However, comparisons of tumor cell numbers and PD-L1 expression in tissues obtained between Cryo and TBB have been unknown.…”

Section: Introductionmentioning

confidence: 99%

Comparison of tumor cell numbers and 22C3 PD-L1 expression between cryobiopsy and transbronchial biopsy with endobronchial ultrasonography-guide sheath for lung cancer

et al. 2019

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Background We previously reported cryobiopsy (Cryo) with endobronchial ultrasonography-guide sheath (EBUS-GS) for peripheral pulmonary lesions (PPLs) provides significantly larger tissues than transbronchial biopsy (TBB) and provides high quantity and quality DNA for gene analysis by next generation sequencing. However, the tumor cell yields and programmed death ligand 1 (PD-L1) expression between each approach have not been compared. Here, we assessed the tumor cell numbers and PD-L1 expression for Cryo with EBUS-GS for PPLs and TBB in patients with lung cancer. Methods Sixteen patients were enrolled in this prospective study from June to November 2017 at Tokyo Women’s Medical University Hospital. The number of tumor cells from a single biopsy, total number of tumor cells, average number of tumor cells, and 22C3 PD-L1 expression (≥ 50% and ≥ 1%) were compared between Cryo and TBB. Results The numbers of tumor cells from a single biopsy, total numbers of tumor cells, and average numbers of tumor cells obtained by Cryo were significantly larger than those obtained by TBB (Cryo [means ± standard errors of the means]: 1321 ± 303.7, 1981 ± 411.7, and 1406 ± 310.3; TBB: 208.8 ± 38.24, 1044 ± 189.0, and 208.8 ± 37.81; P < 0.0001, P = 0.0474, P = 0.0006, respectively). PD-L1 ≥ 50% and ≥ 1% patients for Cryo were 18.8 and 56.3%, respectively, whereas those for TBB were 12.5 and 37.5%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, concordance, and κ coefficient based on Cryo for TBB were 66.7, 100, 100, 92.9, 93.8%, and 0.7647, respectively, for PD-L1 ≥ 50%; and 44.4, 71.4, 66.7, 50, 56.3%, and 0.1515, respectively, for PD-L1 ≥ 1%. Conclusion Cryo with EBUS-GS may be a useful diagnostic approach for lung cancer, with advantages over TBB for gene analysis and whole exon sequencing. Particularly, it could contribute to patients taking pembrolizumab as first-line therapy when PD-L1 was negative by evaluating TBB specimens. It could also provide ample tissue for PD-L1 expression analysis in addition to accurate diagnosis and gene analysis.

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Cryobiopsy with endobronchial ultrasonography using a guide sheath for peripheral pulmonary lesions and DNA analysis by next generation sequencing and rapid on-site evaluation

Cited by 42 publications

References 31 publications

Cryobiopsy increases the EGFR detection rate in non-small cell lung cancer

Cryobiopsy increases the EGFR detection rate in non-small cell lung cancer

Safety and Usefulness of Cryobiopsy and Stamp Cytology for the Diagnosis of Peripheral Pulmonary Lesions

Comparison of tumor cell numbers and 22C3 PD-L1 expression between cryobiopsy and transbronchial biopsy with endobronchial ultrasonography-guide sheath for lung cancer

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