Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2020; 8(21): 5139-5148
Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5139
Accuracy of endoscopic ultrasound-guided needle aspiration specimens for molecular diagnosis of non-small-cell lung carcinoma
Wei Su, Xiang-Dong Tian, Peng Liu, De-Jun Zhou, Fu-Liang Cao
Wei Su, Xiang-Dong Tian, Peng Liu, De-Jun Zhou, Fu-Liang Cao, Department of Endoscopy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
Author contributions: Su W collected and analyzed the data and wrote the paper; Tian XD collected medical record information and searched references; Liu P provided clinical advice and modified the manuscript; Zhou DJ designed the research and supervised the report; Cao FL designed the research and approved final version of paper; All authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81903055; and Tumor Translational Medicine Seed Fund of Tianjin Medical University Cancer Institute and Hospital, No. 1709.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Tianjin Medical University Cancer Institute and Hospital (Approval No. bc2020023).
Informed consent statement: Patients were not required to provide informed consent for this study because the analysis used anonymous clinical data that were obtained after patient had agreed to treatment with written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fu-Liang Cao, MD, Attending Doctor, Department of Endoscopy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, West Huanhu Road, Ti Yuan Bei, Hexi District, Tianjin 300060, China. fuliangcao2008@163.com
Received: June 28, 2020
Peer-review started: June 28, 2020
First decision: July 24, 2020
Revised: August 4, 2020
Accepted: September 25, 2020
Article in press: September 25, 2020
Published online: November 6, 2020
Processing time: 131 Days and 0.1 Hours
ARTICLE HIGHLIGHTS
Research background

Endoscopic ultrasound-guided needle aspiration technology is applied to the diagnosis of lung cancer, which exempts many patients from undergoing more traumatic examinations. It has been gradually promoted in clinical practice. Whether the limited puncture tissue can be used for pathological diagnosis, molecular diagnosis, etc. and obtain reliable results, is the question we wanted to clarify in order to help us understand whether the technology can efficiently assist clinical diagnosis and treatment.

Research motivation

To evaluate the value of endoscopic ultrasound-guided needle aspiration in the diagnosis of lung cancer.

Research objectives

Through retrospective research to understand the success rate of molecular diagnosis of non-small cell lung carcinoma with puncture specimens. To evaluate the reliability of the diagnosis results through follow-up of clinical treatment effects.

Research methods

According to the location of the patient’s lesion, we choose to use endoscopic ultrasonography-guided fine-needle aspiration or endobronchial ultrasound-guided transbronchial needle aspiration. Due to the different accessibility of lung and mediastinal lesions, the two puncture methods are considered to be complementary. We used Sanger sequencing for mutation analysis of EGFR, KRAS, MET and HER2. This is not the most advanced detection method, but the test results are reliable. Moreover, it does not require high costs, so more patients can benefit from it.

Research results

In this study, 93.9% of the punctured tissues met the molecular test standards. The test results were in line with the mutation frequency of the patient population. The patients who received targeted therapy according to the test results responded well. These results add evidence to support the application value of this technology in diagnosis of non-small cell lung carcinoma. However, this study lacks comparison data between this technique and other methods, so it cannot prove that it is the first choice for clinical diagnosis.

Research conclusions

The two puncture methods are considered to be complementary. They can puncture almost all the mediastinal lymph nodes. This technique obtains diseased tissue under minimally invasive conditions, thus reducing unnecessary surgical intervention. The diagnosis results are reliable and can effectively guide clinical treatment.

Research perspectives

Advantages and problems of endoscopic ultrasound in diagnosis and treatment of lung cancer and gastrointestinal tumors.