| Autor: |
David Fielding, FRACP, MD, Andrew J. Dalley, PhD, Mahendra Singh, FRCPA, Lakshmy Nandakumar, FRCPA, Katia Nones, PhD, Vanessa Lakis, MBioinf, Haarika Chittoory, MBiotech, Kaltin Ferguson, Farzad Bashirzadeh, FRACP, Michael Bint, FRACP, Carl Pahoff, FRACP, Jung Hwa Son, RN, Alan Hodgson, CT ASC, Sowmya Sharma, FRCPA, David Godbolt, FRCPA, Kylie Coleman, CT ASC, Lenore Whitfield, CT ASC, Nicola Waddell, PhD, Sunil R. Lakhani, FRCPA, Gunter Hartel, PhD, Peter T. Simpson, PhD |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
|
| Zdroj: |
JTO Clinical and Research Reports, Vol 3, Iss 10, Pp 100403- (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2666-3643 |
| DOI: |
10.1016/j.jtocrr.2022.100403 |
| Popis: |
Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS TBNA) is an important means of obtaining a tissue for advanced lung cancer. Optimizing the EBUS TBNA needling technique is important to maintain procedural simplicity and maximize sample quality for emerging molecular diagnostics. Methods: We prospectively explored three versus 10 agitations of the needle in sequential passes into the lymph node using separate needles. Resulting Diff-Quik cytology smears were quantitatively assessed using microscopic (tumor cell cellularity, abundance scores, erythrocyte contamination) and DNA yields. Microscopy was reported by two cytopathologists, and an inter-rater assessment was made by four additional cytopathologists. Results: In 86 patients confirmed as having malignant disease by EBUS TBNA (45 males, 41 females), a mean of 5.3 smears were made per patient with a total of 459 smears scored by pathologists and 168 paired smears extracted for DNA. There was no significant difference between three versus 10 agitations for smear cellularity (p = 0.44), DNA yield (p = 0.84), or DNA integrity (p = 0.20), but there was significantly less contamination by erythrocytes from three agitations (chi-square p = 0.008). There was significantly more DNA in the first pass into the node using three agitations than with other passes and with 10 agitations (pass × agitations interaction, p = 0.031). Reviewing pathologists correctly classified smears as more than or equal to 25% cellularity 86.3% of the time (κ = 0.63 [95% confidence interval: 0.55–0.71]). Conclusions: Three agitations are noninferior to 10 agitations for overall abundance of malignant cells and DNA content on smears. A smear with adequate DNA for panel sequencing could almost always be made with the first needle pass using three agitations. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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