Open AccessFeasibility of computed tomography‐guided core needle biopsy in producing state‐of‐the‐art clinical management in C hinese lung cancer
Author(s) -
Chen HuaJun,
Yang JinJi,
Fang LiangYi,
Huang MinMin,
Yan HongHong,
Zhang XuChao,
Xu ChongRui,
Wu YiLong
Publication year - 2014
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.12076
Subject(s) - medicine , lung cancer , malignancy , anaplastic lymphoma kinase , biopsy , epidermal growth factor receptor , oncology , radiology , cancer , cohort , clinical trial , pathology , malignant pleural effusion
Background A satisfactory biopsy determines the state‐of‐the‐art management of lung cancer in this era of personalized medicine. This study aimed to investigate the suitability and efficacy of computed tomography ( CT )‐guided core needle biopsy in clinical management. Methods A cohort of 353 patients with clinically suspected lung cancer was enrolled in the study. Patient factors and biopsy variables were recorded. Epidermal growth factor receptor ( EGFR ) gene mutations and echinoderm microtubule‐associated protein‐like 4 ( EML4) ‐anaplastic lymphoma kinase ( ALK ) rearrangement were detected in tumor specimens. Adequacy of biopsic obtainment for clinical trial screening and tissue bank establishment were reviewed. Results Overall diagnostic accuracy of malignancy achieved 98.5%. The median biopsy time of the cohort was 20 minutes. In patients with non‐small cell lung cancer ( NSCLC) , 99.3% (287/289) were diagnosed as specific histologic subtypes, and two patients (0.7%) were determined as NSCLC not otherwise specified ( NOS ). EGFR mutations were analyzed in 81.7% (236/289) of patients with NSCLC , and 98.7% (233/236) showed conclusive results. EML4‐ ALK gene fusion was tested in 43.9% (127/289) of NSCLC patients, and 98.4% (125/127) showed conclusive results: 6.4% (8/125) of those had gene fusion. Ninety‐six NSCLC patients participated in clinical trial screening and provided mandatory tumor slides for molecular profiling. Pathological evaluation was fulfilled in 90 patients (93.8%); 99.4% (320/322) of patients with malignancy provided extra tissue for the establishment of a tumor bank. Conclusions CT ‐guided core needle biopsy provided optimal clinical management in this era of translational medicine. The biopsic modality should be prioritized in selected lung cancer patients.