Comparison of Endobronchial Ultrasound–guided Transbronchial Needle Aspiration With Stylet Retracted Partially Versus Completely for Molecular Testing. Issue 3 (July 2019)

• Record Type: Journal Article
• Authors: Fernandez-Bussy, Sebastian; Biswas, Abhishek; Labarca, Gonzalo; Jantz, Michael A.; Mehta, Hiren J.
• Is Part Of: Journal of bronchology & interventional pulmonology. Volume 26:Issue 3(2019)
• Publication Date: 2019-07
• Subjects: carcinoma -- non–small cell lung -- endoscopic ultrasound–guided fine needle aspiration -- immunotherapy; Bronchoscopy -- Periodicals; Lungs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Lung Diseases -- surgery -- Periodicals; Diagnostic Techniques, Respiratory System -- Periodicals; Bronchi; Bronchoscopy; Lungs -- Diseases; Periodicals; 616.23
• DOI: 10.1097/LBR.0000000000000596
• Languages: English
• ISSNs: 1944-6586

Abstract

Abstract : Background: Endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA) is considered to be the initial diagnostic modality for most patients with lung cancer. However, the optimal technique for maximizing yield continues to vary in the real-world setting. Objectives: To evaluate the diagnostic yield of EBUS-TBNA with capillary sampling compared with complete stylet removal for molecular testing. Methods: Retrospective study, data from patients between January to May 2017 with indication of EBUS-TBNA whom ancillary testing, that is, next-generation sequencing, anaplastic lymphoma kinase ( ALK ), and programed death ligand-1 (PD-L1) expression was reviewed. The yield of 2 techniques, stylet retracted halfway (group 1) versus complete retraction (group 2), was compared. Results: A total of 24/27 (88.88%) samples were adequate for next-generation sequencing analysis in group 1 and 21/23 (91.30%) in group 2. For other molecular analyses, 24/27 (88.88%) samples in group 1 and 20/23 (86.95%) samples in group 2 were adequate for ALK analysis. 23/27 (85.18%) samples for group 1 and 20/23 (86.95%) samples for group 2 were adequate for PD-L1 analysis. Positive expression of PD-L1>50% was achieved in 9/23 (39.13%) of group 1 and 5/20 (25%) of group 2. There was no statistical difference in the yield between the 2 groups. Conclusion: EBUS-TBNA using either capillary sampling or complete stylet removal are effective and has a high proportion of satisfactory results for ancillary testing.