The Clinical Value Of EBUS-TBNA Combining IHC And Molecular Tseting In Lung Cancer

[Objective] To investigate the clinical value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) combining immunohistochemisty (IHC) and molecular testing in lung cancer.[Methods] A total of 58 patients with mediastinal, and/or hilar lymphadenopanthy, and/or mediastinal mass previously detected by CT or PET/CT scan and who underwent EBUS-TBNA between May 2013 and November 2015 was retrospectively reviewed. Additional immunohistological analysis was performed for establishing a reliable diagnosis when necessary. Some samples were tested for the EGFR and/or ALK mutations to provide suitable mutational genotyping for adenocarcinoma.[Results] Of the 58 patients,39 primary lung cancer,3 metastatic lung cancer,1 soft tissue sarcoma,1 lympoma,1 metastatic lymph node adenocarcinoma,4 tuberculosis and 1 reactive lymphadenitis was diagnosed by EBUS-TBNA, nondiagnosed in 8 cases. The diagnostic accuracy, sensitivity, specific, positive predictive value, negative predictive value of EBUS-TBNA in the diagnosis of lung cancer were 94.8%(55/58),92.8%(39/42),100%(16/16), 100%(39/39),84.2%(16/19), respectively.31 samples were further confirmed and obtained definite type by Immunohistochemistry (iHC), nineteen adenocarcinoma of lung,6 lung squamous EBUS-TBNA carcinoma and 6 small cell lung cancer.6 EBUS-TBNA samples from patients with adenocarcinoma of lung referred for EGFR testing were analyzed,4 patients were found to have EGFR gene mutations, ALK-negative 1 cases. The procedure was uneventful without complications.[Conclusions] EBUS-TBNA was a safe and effective method with high sensitivity and specificity in the diagnosis of lung cancer. Especially it combining with IHC and molecular testing have important clinical value in diagnosis and guiding the treatment strategy.