导论不可切除的非小细胞肺癌(NSCLC)患者可能受益于化疗,酪氨酸激酶抑制剂(TKI)治疗,或者两者兼而有之。TKI疗法可给予具有表皮生长因子受体(EGFR)突变的患者亚组。现在,EGFR突变检测在晚期NSCLC患者的诊断工作中起着至关重要的作用,以确定哪些患者更有可能从TKI治疗中受益。手术在这些患者中的作用主要限于获得足够的组织学活检,免疫组织化学,和使用侵入性最小的方法进行EGFR分析。人们认为体积更大的样品,例如从传统的外科肺活检(SLB)获得的那些,比小体积样品有更好的产量,例如从经胸针肺活检(TTNLB)获得的那些,用于EGFR分析。目的这项研究的目的是确定在EricWilliams医学科学中心(EWMSC)的原发性NSCLC患者中,哪些活检程序为EGFR突变分析提供了优异的产量,以及这些组织产量是否符合国际建议。方法这是一项回顾性研究,使用从肺部恶性肿瘤单位获得的患者数据进行观察性研究,这是基于EWMSC。研究人群仅限于2014年1月至2017年6月向EWMSC就诊的原发性NSCLC患者,其活检样本被送往EGFR检测。使用MicrosoftExcel将相关患者数据输入到电子表格中。患者被归类为患有SLB,支气管活检(BB),TTNLB,或者其他活检程序.所有样本都被送去做组织学分析,然后进行免疫组织化学,最后进行EGFR检测。所有EGFR突变分析在美国的单个实验室进行。最少200个肿瘤细胞或10%肿瘤含量定义了用于EGFR突变分析的适当样品。产生阳性或阴性结果的样品被认为是本研究中的适当样品。将每个程序组的充足和不充足样品的数量制成表格,并将产量确定为每个程序组获得的充足样品的百分比。结果在获得用于EGFR分析的足够样品方面,与BB(88.5%)和TTNLB(85%)相比,SLB具有优异的产率(95.6%)。结论SLB在获得用于EGFR突变分析的足够的组织样品方面表现出比BBs和TTNLTs更高的产量。
Introduction Patients with unresectable non-small cell lung cancer (NSCLC) may benefit from chemotherapy, tyrosine kinase inhibitor (TKI) therapy, or both. TKI therapy may be administered to the subset of patients who harbor the epidermal growth factor receptor (EGFR) mutation. EGFR mutation testing now plays a vital role in the diagnostic work-up of advanced NSCLC patients to determine which patients are more likely to benefit from TKI therapy. The role of surgery in these patients is mostly limited to obtaining an adequate biopsy for histological, immunohistochemical, and EGFR analysis using the least invasive methods possible. It is thought that larger volume samples, such as those obtained from traditional surgical lung biopsies (SLBs), have better yield than small volume samples, such as those obtained from transthoracic needle lung biopsies (TTNLBs), for EGFR analysis. Aim The aim of this was to determine which biopsy procedures provide superior yield for EGFR mutation analysis among primary NSCLC patients at the Eric Williams Medical Sciences Complex (EWMSC) and whether these tissue yields are in keeping with international recommendations. Methods This is a retrospective, observational study using patient data obtained from the Lung Malignancy Unit, which is based at the EWMSC. The study population was limited to primary NSCLC patients presenting to the EWMSC from January 2014 to June 2017 whose biopsy samples were sent for EGFR testing. Relevant patient data were entered onto a spreadsheet using Microsoft Excel. Patients were classified as having had either an SLB, bronchial biopsy (BB), TTNLB, or some other biopsy procedure. All samples were sent for histological analysis, followed by immunohistochemistry and finally EGFR testing. All EGFR mutation analysis was performed at a single laboratory in the USA. A minimum of 200 tumor cells or 10% tumor content defined an adequate sample for EGFR mutation analysis. Samples that yielded a positive or negative result were considered adequate samples in this study. The number of adequate and inadequate samples for each procedure group was tabulated and the yield was determined as the percentage of adequate samples obtained for each procedure group. Results SLBs had superior yield (95.6%) compared to BBs (88.5%) and TTNLB (85%) in obtaining adequate samples for EGFR analysis. Conclusion SLBs demonstrated superior yield in attaining adequate tissue samples for EGFR mutation analysis compared to BBs and TTNLBs.