EBUS-TBNA gives adequate tissue information on cell type in lung cancer

ABSTRACT Introduction In formulating systemic treatment in patients with advanced stage lung cancer, it is now considered imperative to know the cell type such as squamous carcinoma, adenocarcinoma and large cell carcinoma as chemotherapeutic agents would be tailored to treat different cell type. Method Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA)was performed under local anaesthesia in patients presented with mediastinal abnormality suspected of or confirmed lung cancer for diagnosis and staging purpose. Once malignancy was confirmed from the pathological materials, exact cell type, origin of tumour, differentiation were recorded. In the later phase of the study period, molecular profiling was also deployed to confirm the EGFR mutation and ALK translocation status. Results Over the study period of 4 years and 4 months, there were 269 EBUS-TBNA performed in 258 patients. Of the 209 patients confirmed having malignancy as their final diagnosis, EBUS-TBNA was able to detect extrathoracic malignancy in 23 (11.0%) and primary lung cancer in 133 (63.6%). Among those 133 patients confirmed having primary lung cancer, 116 (87.2%) had exact cell type delineated. For those 40 patients who had molecular profiling performed, patients with adequate tissue for EGFR mutation and/or ALK translocation were obtained in 38 (95.0%). Of the 157 patients confirmed to have malignancy by EBUS-TBNA, only 22 (14%) had revealed NSCLC without knowing the exact cell type, differentiation of the tumour, EGFR status or primary origin of the tumour. In the 220 patients with final diagnosis of malignancy, the sensitivity was 89.0% and negative predictive value was 65.0% Conclusion EBUS-TBNA is effective in subtyping of tumour cells and molecular profiling in patients with lung cancer. Disclosure All authors have declared no conflicts of interest.