SESSION TYPE: Lung Cancer I
PRESENTED ON: Sunday, October 21, 2012 at 10:30 AM - 11:45 AM
PURPOSE: To evaluate the adequacy of tissue samples obtained from bronchoscopy guided by electromagnetic navigation (ENB) for histologic and molecular characterization of lung cancer.
METHODS: We retrospectively analyzed patients who underwent ENB for diagnosis of a lung nodule or mass. In those proven to be a primary lung cancer by tissue obtained during the ENB, the adequacy of the tissue for a specific histological subtype was recorded. The accuracy of histologic characterization was determined by comparison with resected specimens when available. Adenocarcinomas in which epidermal growth factor receptor (EGFR) mutation and/or anaplastic lymphoma kinase (ALK) gene rearrangement analyses were attempted were reviewed for the adequacy of tissue for these analyses.
RESULTS: Sixty ENB cases resulted in a diagnosis of lung cancer. The tissue obtained was considered adequate for histologic classification in all 60 lesions. Forty (66.7%) were diagnosed with adenocarcinoma, 17 (28.3%) with squamous cell carcinoma, and 3 (5%) with small cell lung cancer. Sixteen of the 60 tumors underwent surgical resection. The concordance in the histologic classification between ENB and the surgical specimen was 87.5% (14 tumors). One ENB classification of adenocarcinoma was a large cell carcinoma, and one squamous cell carcinoma was an adenosquamous carcinoma. Tissues from 14 cases of adenocarcinoma were sent for EGFR mutation analysis. Thirteen tissue samples (92.9%) were adequate while 1 (7.7%) was inadequate for analysis. One was positive for an EGFR mutation. Tissue from 2 cases was used for ALK gene rearrangements, both of which were considered adequate for analysis; one was positive.
CONCLUSIONS: ENB is effective at obtaining tissue samples adequate for histological and molecular characterization of lung cancer.
CLINICAL IMPLICATIONS: Diagnostic specimens obtained by ENB are usually adequate for accurate histological and molecular characterization of lung cancer, allowing us to avoid more invasive techniques for tissue acquisition.
DISCLOSURE: The following authors have nothing to disclose: Duc Ha, Humberto Choi, Francisco Almeida, Valeria Arrossi, Jennifer Brainard, Joseph Cicenia, Carol Farver, Thomas Gildea, Michael Machuzak, Peter Mazzone
No Product/Research Disclosure InformationCleveland Clinic - Department of Internal Medicine, Cleveland, OH