Role of endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer management

Abstract

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a low-invasive modality that shows excellent sensitivity, specificity, and accuracy in the diagnosis of nodal metastasis of lung cancer. Thus, EBUS-TBNA has become the first choice for nodal staging of non-small cell lung cancer and an alternative to mediastinoscopy, which had long been the gold standard. EBUS-TBNA can be utilized not only for initial cancer staging but also for staging after treatment or for diagnostic purposes, including molecular diagnostics. Adequate specimens can be obtained by EBUS-TBNA for the molecular analysis of various genetic alterations and immunohistochemical analyses. The ultrasound technology utilized in EBUS keeps evolving, especially ultrasound imaging, which allows for adequate sampling of the most suspicious lesions. Minimally invasive chronological sampling allows for the evaluation of lesions molecularly or pathologically. Areas covered: We discuss the current applications and future direction of EBUS-TBNA in this review. Expert opinion: EBUS-TBNA is an essential tool for evaluating patients since it obtains high-quality pathological samples with a low degree of invasiveness in the precision medicine era of lung cancer management.

Keywords: Biomarker; EBUS-TBNA; lung cancer; lymph node; metastasis; minimally invasive; nodal staging of lung cancer; precision diagnosis; precision medicine; staging.