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. 2014 Nov 10:7:2061-5.
doi: 10.2147/OTT.S72974. eCollection 2014.

Efficient utilization of EBUS-TBNA samples for both diagnosis and molecular analyses

F Oezkan  1 , Am Khan  2 , P Zarogoulidis  3 , W Hohenforst-Schmidt  4 , D Theegarten  5 , K Yasufuku  2 , T Nakajima  6 , L Freitag  1 , K Darwiche  1
Affiliations

Efficient utilization of EBUS-TBNA samples for both diagnosis and molecular analyses

F Oezkan et al. Onco Targets Ther. .

Abstract

Background: The assessment of an increasing number of molecular markers is becoming a standard requirement from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) specimens. However, it is unclear how many needle passes should be performed and the amount of lung cancer cells that should be sent for molecular analyses. The objective of this study was to determine if it is feasible to divide the material obtained by EBUS-TBNA to allow for molecular analysis without compromising the accuracy of mediastinal staging.

Objective: We aimed to determine if dividing EBUS-TBNA specimens has a negative impact on either histopathological diagnosis or molecular analysis.

Methods: EBUS-TBNA was performed in 249 enlarged lymph nodes. Negative or ambiguous histopathological results were confirmed by surgical means and clinical follow-up over 6 months. The tissue obtained by EBUS-TBNA was placed onto a glass slide and divided for histopathological workup and molecular analysis. The number of passes was recorded. Both the accuracy of the mediastinal lymph node staging and the applicability of the sample division for molecular analysis were assessed.

Results: Each lymph node was punctured an average of 3.18 times and division of the obtained material for diagnosis and molecular analysis was feasible in all cases. The sensitivity and accuracy of the mediastinal lymph node staging were 96.6% and 97.6%, respectively. A cytokeratin (CK)-19-mRNA concentration-based molecular test was feasible in 74.1% of cases.

Conclusion: Dividing EBUS-TBNA samples for both histopathological diagnosis and molecular testing is feasible and does not compromise the accuracy of mediastinal staging. This method may be an alternative to taking additional needle passes for molecular analyses.

Keywords: CK-19-mRNA; lung cancer; lymph node sampling; molecular marker.

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Figures

Figure 1
Figure 1
Flowchart of the lymph nodes evaluated in the study (CONSORT). Abbreviations: EBUS-TBNA, endobronchial ultrasound-guided transbronchial needle aspiration; LN, lymph nodes.
Figure 2
Figure 2
EBUS-TBNA material is placed onto a glass slide, mixed, and divided into two equivalent parts and sent for histopathological and molecular analysis, respectively. The glass slide is then referred to fast track cytological evaluation. Abbreviation: EBUS-TBNA, endobronchial ultrasound-guided transbronchial needle aspiration.
See this image and copyright information in PMC

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