M13 Outpatient ultrasound-guided fine-needle aspiration of supraclavicular lymph nodes, performed by chest physicians for diagnosis and staging of lung cancer

Abstract

TBNA histology specimens using both 21G and 22G needles in confirmed primary lung adenocarcinoma. Methods A prospective analysis was performed on 250 consecutive patients undergoing EBUS-TBNA between 2009 and 2013. 21G or 22G needles (Olympus ViziShot, NA-201SX-4021 and NA-201SX-4022) were used by operator discretion. A minimum of 2 passes were carried out per nodal station. Samples were fixed in formalin and prepared for histopathological analysis. The proportion of confirmed primary lung adenocarcinoma samples in which EGFR mutation testing was feasible was determined. Results Primary lung adenocarcinoma was confirmed in 45 patients (18%). EGFR mutation analysis was attempted in 35 of these patients and was possible in 34 (97.1%). EGFR mutation was present in 3 patients (8.8%). Conclusions This single centre study demonstrates both 22G and 21G EBUS-TBNA samples are adequate for EGFR mutation analysis with no clear superiority in contrast to recent data suggesting disease phenotyping may be superior using a 21G needle when analysed by histopathology. We speculate that higher sample usability rates for mutation analysis may have been facilitated by the use of histological specimens however further larger studies are required to confirm this hypothesis. M12 EBUS-ARE TWO NEEDLES BETTER THAN ONE?WA Khan, S Bailey, M Najib; Manchester Royal Infirmary, Manchester, England 10. 1136/thoraxjnl-2013-204457.422 Introduction The introduction of endobronchial ultrasound has allowed visual sampling of nodes compared to the previous blind TBNA techniques. It was widely been used for patients with suspected lung. The purpose of our current study was to evaluate the usefulness of using a 2 needle technique compared to a single needle method in ebus sampling. The primary endpoint was to see the effect on the total number of biopsy passes, time between needle exchange and also total time taken to complete an ebus procedure. Method 20 patients with mediastinal and hilar lymphadenopathy or suspected lung cancer in our institution were included in this prospective study. EBUS-TBNA was performed in all cases. 10 procedures were used using a 2 needle technique and 10 procedures were performed with single needle. Two trained bronchoscopists with 2 trained nurses performing the needle exchange and on site cytopathologist were present at the bronchoscopy giving an instant preliminary diagnosis.Equal numbers of procedures were performed by each of the operators. Results EBUS-TBNA was successfully performed in all 20 patients recruited. In the single needle technique the average number biopsy passes performed was 3.8 per ebus with an average needle changeover delay of 2 minutes 21 seconds and an average ebus time of 27 minutes. The two needle technique showed a greater number biopsy passes of 4.4 per ebus with a significantly reduced changeover needle time delay of 18 seconds per changeover and a reduction in overall ebus time to 21 minutes per procedure. All the procedures were uneventful without complications. All sample were labe...