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S. Marran
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P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.04-018 - The Value of Histopathological Examination for Bronchoscopic Ultrasound Guided Fine-Needle Aspiration in Diagnosis of Lung Cancer Subtypes (ID 1151)
09:30 - 09:30 | Author(s): S. Marran
- Abstract
Background:
The role of endobronchial ultrasound (EBUS) and transesophageal bronchoscopic ultrasound (EUS-B)-guided fine-needle aspiration (FNA) of intrathoracic lymphnodes has acquired paramount importance in obtaining definitive diagnosis in malignant diseases. Recently, the diagnostic value of cell block processing of EBUS-FNA samples to obtain accurate distinction between lung cancer subtypes has been studied, but the diagnostic yield have been marginally investigated in a larger cohort of patients.
Methods:
We review tertiary hospital experience with EBUS-FNA and EUS-B-FNA in obtaining tissue diagnosis for lung cancer and evaluate, if the cell block processing method increases diagnostic accuracy in pathological lung cancer subtyping. The pathological examination was based on smear cytology (SC) and cell block preparation (CBP) routinely obtained during EBUS (EUS-B)-FNA. After cell block embedding in paraffin and sectioning at 3 micrometer hematoxylin and eosin staining and if required immunostaining was available for microscopical histopathological examination.
Results:
From January 2011 to December 2013, 608 patients, including 208 lung cancer patients with mediastinal and hilar lymphnodes pathology, underwent EBUS-FNA or simultaneous EUS-B-FNA in North Estonia Medical Center. In lung cancer patients cytological assessment was performed in all 208 cases. Formalin fixed paraffin-embedded cell block for histopathological examination was available in 196 (94.2%) cases. The overall morphological verification rate in CBP group was 85.6% (n=178) and in SC group 79.3% (n=165). The pathological diagnosis of undifferentiated type of lung cancer was provided in 43.7% (n=91) of CBP cases and in 35.6% (n=74) of SC cases. Diagnostic yield in pathological subtyping of lung cancer was significantly higher in CPB compare to SC: 81.2 % (n=169) vs. 43.7% (n=91), respectively (p<0.005). Adding CBP to SC provided an accurate subtyping of lung cancer in 102 more patients and the diagnostic efficacy was increased by 49.0% (n=102/208) (p<0.005).
Conclusion:
Cell block processing method combined with smear cytology obtained from intrathoracic lymphnodes applying EBUS (EUS-B)-FNA significantly increases diagnostic yield in pathologic lung cancer subtyping. Both tissue processing techniques should be routinely applied simultaneously whenever possible with aim to facilitate clinical decision and make impact on lung cancer patients outcome.
