PDF(Pubmed)
Abstract：
UNASSIGNED: In lung cancer, molecular testing and next-generation sequencing (NGS) are needed to identify therapeutic targets and are increasingly being used in earlier stages of the disease. Despite its longstanding use, it remains unclear whether transbronchial needle aspiration (TBNA) of peripheral lung lesions provides as adequate material for genetic testing as transbronchial forceps biopsies (TBFBs). In this study, we aim to analyze the use of TBNA using median viable cell area (MVCA) as a surrogate parameter to analyze sample quality.
UNASSIGNED: This prospective single-center study analyzed biopsy specimens or aspirates of patients who underwent bronchoscopy with transbronchial biopsy. Patients underwent bronchoscopy with TBFB and TBNA for suspected lung cancer in peripheral lung lesions. Patients were randomized 1:1 to receive either TBFB or TBNA as the first biopsy technique and then switched to the other. After routine workup, sample slides were digitally scanned, and MVCA was calculated by a pathologist blinded to the biopsy technique used. The primary endpoint was MVCA of TBNA versus TBFB. Secondary endpoints were complications categorized as bleeding, pneumothorax, and other.
UNASSIGNED: Between August 2021 and April 2022, 15 patients were included in the per-protocol analysis. Six patients were included in cohort 1 and nine patients in cohort 2. A malignant diagnosis was confirmed in 11/15 (73.3%) cases, of which nine were primary lung malignancies. Overall, MVCA in samples obtained by TBFB was significantly larger than TBNA samples {TBFB-MVCA 9.80 mm2 [interquartile range (IQR), 2.70-10.39 mm2] vs. TBNA-MVCA 2.70 mm2 (IQR, 0.14-8.21 mm2), P=0.008}. Despite this difference, molecular testing was feasible in both TBNA and TBFB samples. No major complications were observed.
UNASSIGNED: Despite a significantly smaller MVCA provided by TBNA, samples were still considered feasible for NGS, indicating that TBNA represents an alternative method to obtain sufficient tumor tissue in peripheral nodules as part of the diagnosis of suspected lung cancer.
UNASSIGNED: This prospective single-center study analyzed biopsy specimens or aspirates of patients who underwent bronchoscopy with transbronchial biopsy. Patients underwent bronchoscopy with TBFB and TBNA for suspected lung cancer in peripheral lung lesions. Patients were randomized 1:1 to receive either TBFB or TBNA as the first biopsy technique and then switched to the other. After routine workup, sample slides were digitally scanned, and MVCA was calculated by a pathologist blinded to the biopsy technique used. The primary endpoint was MVCA of TBNA versus TBFB. Secondary endpoints were complications categorized as bleeding, pneumothorax, and other.
UNASSIGNED: Between August 2021 and April 2022, 15 patients were included in the per-protocol analysis. Six patients were included in cohort 1 and nine patients in cohort 2. A malignant diagnosis was confirmed in 11/15 (73.3%) cases, of which nine were primary lung malignancies. Overall, MVCA in samples obtained by TBFB was significantly larger than TBNA samples {TBFB-MVCA 9.80 mm2 [interquartile range (IQR), 2.70-10.39 mm2] vs. TBNA-MVCA 2.70 mm2 (IQR, 0.14-8.21 mm2), P=0.008}. Despite this difference, molecular testing was feasible in both TBNA and TBFB samples. No major complications were observed.
UNASSIGNED: Despite a significantly smaller MVCA provided by TBNA, samples were still considered feasible for NGS, indicating that TBNA represents an alternative method to obtain sufficient tumor tissue in peripheral nodules as part of the diagnosis of suspected lung cancer.
摘要：
■在肺癌中，需要分子检测和下一代测序(NGS)来确定治疗靶标,并且越来越多地用于疾病的早期阶段.尽管它长期使用，目前尚不清楚经支气管针吸活检术(TBNA)对周围型肺病变是否像经支气管钳活检术(TBFBs)一样为基因检测提供了足够的材料.在这项研究中,我们的目标是使用中位活细胞面积(MVCA)作为分析样品质量的替代参数来分析TBNA.
■这项前瞻性单中心研究分析了接受支气管镜和经支气管活检的患者的活检标本或抽吸物。患者在周围性肺病变中接受了TBFB和TBNA的支气管镜检查，以怀疑肺癌。患者以1：1的比例随机接受TBFB或TBNA作为第一种活检技术，然后切换到另一种活检技术。例行检查后,样品载玻片进行了数字扫描，和MVCA由对所用活检技术不知情的病理学家计算。主要终点是TBNA与TBFB的MVCA。次要终点是并发症分类为出血，气胸,和其他。
■在2021年8月至2022年4月之间，15名患者被纳入符合方案分析。队列1中包括6名患者，队列2中包括9名患者。11/15(73.3%)例确诊为恶性诊断,其中9例是原发性肺部恶性肿瘤。总的来说,通过TBFB获得的样品中的MVCA明显大于TBNA样品{TBFB-MVCA9.80mm2[四分位间距(IQR)，2.70-10.39mm2]vs.TBNA-MVCA2.70mm2(IQR,0.14-8.21mm2),P=0.008}。尽管有这种差异,分子测试在TBNA和TBFB样品中都是可行的。未观察到重大并发症。
■尽管TBNA提供了明显较小的MVCA，样品仍然被认为对NGS是可行的，这表明TBNA是在周围结节中获得足够肿瘤组织的替代方法，作为疑似肺癌诊断的一部分。
■这项前瞻性单中心研究分析了接受支气管镜和经支气管活检的患者的活检标本或抽吸物。患者在周围性肺病变中接受了TBFB和TBNA的支气管镜检查，以怀疑肺癌。患者以1：1的比例随机接受TBFB或TBNA作为第一种活检技术，然后切换到另一种活检技术。例行检查后,样品载玻片进行了数字扫描，和MVCA由对所用活检技术不知情的病理学家计算。主要终点是TBNA与TBFB的MVCA。次要终点是并发症分类为出血，气胸,和其他。
■在2021年8月至2022年4月之间，15名患者被纳入符合方案分析。队列1中包括6名患者，队列2中包括9名患者。11/15(73.3%)例确诊为恶性诊断,其中9例是原发性肺部恶性肿瘤。总的来说,通过TBFB获得的样品中的MVCA明显大于TBNA样品{TBFB-MVCA9.80mm2[四分位间距(IQR)，2.70-10.39mm2]vs.TBNA-MVCA2.70mm2(IQR,0.14-8.21mm2),P=0.008}。尽管有这种差异,分子测试在TBNA和TBFB样品中都是可行的。未观察到重大并发症。
■尽管TBNA提供了明显较小的MVCA，样品仍然被认为对NGS是可行的，这表明TBNA是在周围结节中获得足够肿瘤组织的替代方法，作为疑似肺癌诊断的一部分。
