Abstract
Background
Lung cancer is the major cause of cancer death worldwide. Mediastinal lymph node staging
is important for pretreatment lung cancer management. Endobronchial ultrasound-guided
transbronchial needle aspiration (EBUS-TBNA) is a well established method for mediastinal
lymph node staging. Although EBUS-TBNA samples are much smaller than surgical lymph
node biopsies, histopathological evaluation and molecular testing can successfully
be performed. One step nucleic acid amplification (OSNA), which measures cytokeratin
19 (CK19) mRNA concentration, is a target marker that is gaining importance in quick
detection of lymph node metastases in breast cancer and other cancers. Recent publications
suggest accurate and rapid detection of lung cancer metastases in surgically removed
lymph nodes. In this study we aimed to investigate if CK19 mRNA detection via OSNA
is feasible to accurately detect lymph node metastases in lung cancer patients using
EBUS-TBNA samples.
Materials and Methods
A total of 102 EBUS-TBNA samples of 55 patients were collected. EBUS-TBNA was performed
in lymph nodes exceeding 5 mm. OSNA was performed using a ready to use amplification
kit (Lynoamp; Sysmex, Kobe, Japan) in the RD-100 I, an automated real-time detection
system (Sysmex).
Results
Histopathological analysis confirmed malignancy in 90 cases and excluded malignancy
in 12 cases. Overall sensitivity, specificity, positive predictive value, negative
predictive value, and accuracy were 78.9%, 58.3%, 93.4%, 26.9%, and 76.5%, respectively.
Conclusions
One step nucleic acid amplification is feasible for EBUS-TBNA lymph node samples of
lung cancer patients, but CK19 mRNA is an inaccurate marker, which is unlikely to
be useful as an adjuvant test for EBUS-TBNA. Further studies are required to define
the optimal sample size and sampling method.
Keywords
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Article info
Publication history
Published online: September 18, 2015
Accepted:
September 11,
2015
Received in revised form:
September 3,
2015
Received:
June 22,
2015
Footnotes
Clinical Trials.gov NCT02157857.
Identification
Copyright
© 2015 Elsevier Inc. All rights reserved.
