WCLC 2025 - Posters & ePosters-PT1.05.01 Impact of Endobronchial Ultrasound-Guided Intranodal Forceps Biopsy on Next-Generation Sequencing

PT1.05.01 Impact of Endobronchial Ultrasound-Guided Intranodal Forceps Biopsy on Next-Generation Sequencing

Pdf Summary

This retrospective study assessed the impact of adding endobronchial ultrasound-guided intranodal forceps biopsy (IFB) to transbronchial needle aspiration (TBNA) on the success of next-generation sequencing (NGS) in diagnosing non-small cell lung cancer (NSCLC) from lymph node specimens. Between April 2020 and March 2024, 1,414 EBUS-TBNA cases were performed, from which 325 NSCLC cases with NGS ordered were analyzed: 50 had TBNA alone, and 275 had combined TBNA and IFB.<br /><br />Results showed that the combined IFB and TBNA group had significantly higher specimen adequacy (94.9% vs. 78.0%) and NGS success rates (88.0% vs. 76.0%) than the TBNA-only group. Multivariate analysis identified the use of IFB as an independent factor positively associated with NGS success. The main cause of NGS failure was insufficient specimen volume, occurring in 51.1% of failures overall, predominantly affecting TBNA-only cases (91.6%) compared to combined cases (36.3%). IFB allows collection of larger, higher-quality tissue specimens than TBNA’s cytological samples, overcoming challenges like necrotic lesions where TBNA often yields inadequate material.<br /><br />Clinically, the cohort mostly consisted of elderly male smokers with mediastinal lymph node involvement and adenocarcinoma histology. Complications were low and comparable between groups, with no severe bleeding reported.<br /><br />In conclusion, incorporating standard-sized IFB alongside TBNA significantly improves the yield and quality of biopsy specimens for molecular analysis, enhancing NGS adequacy and success rates. IFB serves as a valuable adjunctive diagnostic tool, especially when TBNA alone cannot obtain sufficient samples, potentially enabling better personalized treatment decisions for NSCLC patients.

Asset Subtitle

Kenya Sato

Meta Tag

Speaker Kenya Sato

Topic Pulmonology and Staging

Keywords

endobronchial ultrasound

intranodal forceps biopsy

transbronchial needle aspiration

next-generation sequencing

non-small cell lung cancer

lymph node biopsy

specimen adequacy

molecular analysis

diagnostic yield

personalized treatment