Are EUS-FNA and EBUS-TBNA specimens reliable for subtyping non-small cell lung cancer?

作者：Tournoy K G^*; Carprieaux M; Deschepper E; van Meerbeeck J P; Praet M

来源：Lung Cancer, 2012, 76(1): 46-50.

DOI：10.1016/j.lungcan.2011.09.004

• Endoscopic ultrasound
• Fine needle aspirates
• Histology
• Non-small cell lung carcinoma
• Subtyping

With endosonography, the diagnosis and staging of non-small cell lung cancer (NSCLC) increasingly relies on small samples. The discrimination between squamous and non-squamous subtypes is now important for therapy tailoring. We analyzed the agreement between fine needle aspirates obtained by endosonography and matched biopsy samples for subtyping NSCLC. Patients with a positive endoscopic fine needle aspirate and a matched biopsy were identified. The level of diagnostic agreement was estimated with biopsy samples as golden standard. %26lt;br%26gt;In 951 patients investigated with endosonography, we identified 92 with NSCLC on the positive fine needle aspirate and on the matched biopsy. Squamous cell carcinoma was diagnosed in 34(37%) and 44 (48%) of fine needle aspirate and biopsy samples; while non-squamous carcinoma was diagnosed in 58 (63%) and 48 (52%) respectively. The agreement between needle aspirate and biopsy for the subtyping of NSCLC was 76% (kappa = 0.52). In cases with cell block preparation, the agreement for subtyping was 96% (kappa = 0.91) vs 69% (kappa = 0.39) in cases without cell blocks. %26lt;br%26gt;Therefore, the diagnostic agreement between endosonographic fine needle aspirates and biopsy specimens for subtyping NSCLC is moderate with a disagreement in 1 out of 4 patients. However, cell block preparation increased the agreement and thus the reliability of the fine needle specimens obtained during endosonography, for subtyping NSCLC considerably. %26lt;br%26gt;In conclusion, for patients with NSCLC in whom subtyping is relevant, a diagnostic technique yielding larger samples (FNA with cell block preparation or biopsies) should be preferred.

• 出版日期2012-4