RT Journal Article
SR Electronic
T1 Role of molecular and cellular techniques applied to EBUS-TBNA of mediastinal lymph nodes for lung cancer staging
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 3256
VO 40
IS Suppl 56
A1 Antonio Bugalho
A1 Gloria Nunes
A1 Manuela Correia
A1 Catarina Martins
A1 Sara S. Dias
A1 Paula A. Videira
A1 Maria João Marques Gomes
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/3256.abstract
AB Introduction: Accurate NSCLC staging is of major importance since it dictates the choice of treatment and prognosis. EBUS-TBNA is a minimally invasive method to sample mediastinal lymph nodes. The concomitant identification of cancer biomarkers is important to improve EBUS-TBNA staging.Aim: Assess the feasibility and role of EBUS-TBNA combined to the identification of tumour-associated antigens and tumour-associated immune responses to diagnose lymph node metastases and pathological characteristics in lymph node aspirates.Methods: In a prospective study, EBUS-TBNA samples from 57 patients with confirmed or suspected lung cancer were analysed by cytopathology, flow cytometry (FACS) and reverse-transcriptase polymerase chain reaction (RT-PCR). Results: All samples were adequately processed by the 3 different techniques. Among the 47 samples diagnosed with tumour cell by cytopathology, 70% showed the presence of cytokeratin-19 (CK-19) cells by FACS and 83% of the SCLC were CK-19 negative. CK-19 phenotype and gene expression were significantly correlated (r= 0.901) and cells with this phenotype also expressed CEA, sialyl Lewis X and CD44+ in 22.2%, 25.0% and 18.7% of cases. The expression of the EPCAM gene was significantly higher in the cytopathologically diagnosed cases (p=0.03). The analysis of immune cells profile in the aspirates of these patients revealed a decrease in total leukocytes (p=0.022) and a increase in monocytes (p= 0.039).Conclusions: The combination of molecular and cellular biology techniques with EBUS-TBNA might be a feasible option to improve NSCLC staging and offer an individualized diagnostic and therapeutic approach to lung cancer patients.