7 research outputs found

    Initial Polish experience of Flexible 19 gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

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    ┬á INTRODUCTION: EBUS is a well established minimally invasive diagnostic tool for mediastinal and hilar lymphadenopathy. The novel ViziShot Flex 19G needle (Olympus Respiratory America, Redmond, WA, USA) was introduced in 2015 in order to improve loaded scope flexion and to obtain larger tissue samples for analysis. The aims of this study were to assess diagnostic yield of Flex 19G needles and to present endoscopistÔÇÖs feedback about the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). MATERIAL AND METHODS: The Flex 19G needles were used in patients with hilar and/or mediastinal adenopathy in two Polish pulmonology centers. Cytology smears and cell blocks (CB) were prepared. The prospective analysis was performed due to collected data. RESULTS: Twenty two selected patients with confirmed adenopathy on chest-CT (mean age 58 ┬▒ 12) underwent EBUS-TBNA with use of Flex 19G needles. All procedures occurred to be diagnostic for smears (yield 100%). The malignancy was found in 15 cases (68.2%), and benign adenopathy in 7 (31.8%). In 12 of 14 cases of lung cancer (yield 85.7%) CB were diagnostic for immunohistochemical and molecular staining. After puncturing nodes, especially in hilar position not extensive bleeding was observed. Comparing to standard 21/22G EBUS-TBNA endoscopists underlined better flexion of loaded scope and sample adequacy and found non-significant differences in another biopsy details. CONCLUSIONS: The first Polish experience with use of Flex 19G EBUS-TBNA needle occurs to be similar in performance with standard technique with use of 22/21G needles and presents high diagnostic yield for lung cancer diagnostics, especially when preparing CB. A safety profile of the biopsy is acceptable.

    Initial Polish experience of flexible 19 gauge endobronchial ultrasound-guided transbronchial needle aspiration

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    Introduction: EBUS is a well established minimally invasive diagnostic tool for mediastinal and hilar lymphadenopathy. The novel ViziShot Flex 19G needle (Olympus Respiratory America, Redmond, WA, USA) was introduced in 2015 in order to improve loaded scope flexion and to obtain larger tissue samples for analysis. The aims of this study were to assess diagnostic yield of Flex 19G needles and to present endoscopistÔÇÖs feedback about the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Material and methods: The Flex 19G needles were used in patients with hilar and/or mediastinal adenopathy in two Polish pulmonology centers. Cytology smears and cell blocks (CB) were prepared. The prospective analysis was performed due to collected data. Results: Twenty two selected patients with confirmed adenopathy on chest-CT (mean age 58 ┬▒ 12) underwent EBUS-TBNA with use of Flex 19G needles. All procedures occurred to be diagnostic for smears (yield 100%). The malignancy was found in 15 cases (68.2%), and benign adenopathy in 7 (31.8%). In 12 of 14 cases of lung cancer (yield 85.7%) CB were diagnostic for immunohistochemical and molecular staining. After puncturing nodes, especially in hilar position not extensive bleeding was observed. Comparing to standard 21/22G EBUS-TBNA endoscopists underlined better flexion of loaded scope and sample adequacy and found non-significant differences in another biopsy details. Conclusions: The first Polish experience with use of Flex 19G EBUS-TBNA needle occurs to be similar in performance with standard technique with use of 22/21G needles and presents high diagnostic yield for lung cancer diagnostics, especially when preparing CB. A safety profile of the biopsy is acceptable

    Wst─Öpne polskie do┼Ťwiadczenia z u┼╝yciem ig┼éy Flex 19G do przezoskrzelowej biopsji pod kontrol─ů ultrasonografii wewn─ůtrzoskrzelowej

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    WST─śP: EBUS (endobronchial ultrasonography) jest ma┼éoinwazyjn─ů metod─ů diagnostyczn─ů o dobrze ugruntowanej pozycji w diagnostyce limfadenopatii ┼Ťr├│dpiersia i wn─Ök p┼éucnych. ViziShotFlex 19G needle to nowa ig┼éa przeznaczona do zastosowania w tym badaniu wprowadzona na rynek przez firm─Ö Olympus w 2015 roku. Jej konstrukcja ma zapewni─ç wi─Öksz─ů gi─Ötko┼Ť─ç uzbrojonego endoskopu oraz uzyskanie wi─Ökszej ilo┼Ťci materia┼éu tkankowego do analizy. Cele niniejszej pracy to ocena wydolno┼Ťci diagnostycznej procedury EBUS-TBNA (EBUS ÔÇö transbronchial needle aspiration) z zastosowaniem ig┼éy Flex 19G oraz prezentacja opinii endoskopist├│w na temat badania z jej u┼╝yciem. MATERIA┼ü I METODY: Ig┼éy Flex 19G zastosowano w diagnostyce pacjent├│w z adenopati─ů ┼Ťr├│dpiersia i/lub wn─Ök w dw├│ch o┼Ťrodkach pulmonologicznych w Polsce. Wykonywano zar├│wno rozmazy cytologiczne, jak i bloki kom├│rkowe (CB ÔÇö cell blocks). Dokonano prospektywnej analizy zebranych danych. WYNIKI: Dwudziestu dw├│ch wybranych pacjent├│w z adenopati─ů potwierdzon─ů w tomografii komputerowej (┼Ťrednia wieku 58 ┬▒ 12 lat) podano badaniu EBUS-TBNA z u┼╝yciem igie┼é Flex 19G. Wszystkie wykonane rozmazy cytologiczne okaza┼éy si─Ö diagnostyczne (wydolno┼Ť─ç diagnostyczna 100%). Z┼éo┼Ťliwy charakter zmiany stwierdzono w 15 przypadkach (68,2%), natomiast ┼éagodn─ů adenopati─Ö u 7 pacjent├│w (31,8%). W 12 z 14 przypadk├│w raka p┼éuca wykonane CB mog┼éy by─ç u┼╝yte do oznacze┼ä immunohistochemicznych i molekularnych. Po biopsji w─Öz┼é├│w ch┼éonnych, zw┼éaszcza wn─Ökowych, nie obserwowano nasilonego krwawienia. W por├│wnaniu ze standardow─ů procedur─ů EBUS-TBNA z u┼╝yciem ig┼éy 21/22G endoskopi┼Ťci podkre┼Ťlali wi─Öksz─ů gi─Ötko┼Ť─ç uzbrojonego endoskopu oraz jako┼Ť─ç bioptatu, natomiast w pozosta┼éych aspektach biopsji r├│┼╝nice by┼éy nieznacz─ůce. WNIOSKI: Pierwsze polskie do┼Ťwiadczenia z u┼╝yciem igie┼é Flex 19G okazuj─ů si─Ö by─ç podobne do standardowej techniki z u┼╝yciem igie┼é 21/22G oraz prezentuj─ů wysok─ů wydolno┼Ť─ç diagnostyczn─ů w raku p┼éuca, szczeg├│lnie z zastosowaniem CB. Profil bezpiecze┼ästwa biopsji jest akceptowalny.WST─śP: EBUS (endobronchial ultrasonography) jest ma┼éoinwazyjn─ů metod─ů diagnostyczn─ů o dobrze ugruntowanej pozycji w diagnostyce limfadenopatii ┼Ťr├│dpiersia i wn─Ök p┼éucnych. ViziShotFlex 19G needle to nowa ig┼éa przeznaczona do zastosowania w tym badaniu wprowadzona na rynek przez firm─Ö Olympus w 2015 roku. Jej konstrukcja ma zapewni─ç wi─Öksz─ů gi─Ötko┼Ť─ç uzbrojonego endoskopu oraz uzyskanie wi─Ökszej ilo┼Ťci materia┼éu tkankowego do analizy. Cele niniejszej pracy to ocena wydolno┼Ťci diagnostycznej procedury EBUS-TBNA (EBUS ÔÇö transbronchial needle aspiration) z zastosowaniem ig┼éy Flex 19G oraz prezentacja opinii endoskopist├│w na temat badania z jej u┼╝yciem. MATERIA┼ü I METODY: Ig┼éy Flex 19G zastosowano w diagnostyce pacjent├│w z adenopati─ů ┼Ťr├│dpiersia i/lub wn─Ök w dw├│ch o┼Ťrodkach pulmonologicznych w Polsce. Wykonywano zar├│wno rozmazy cytologiczne, jak i bloki kom├│rkowe (CB ÔÇö cell blocks). Dokonano prospektywnej analizy zebranych danych. WYNIKI: Dwudziestu dw├│ch wybranych pacjent├│w z adenopati─ů potwierdzon─ů w tomografii komputerowej (┼Ťrednia wieku 58 ┬▒ 12 lat) podano badaniu EBUS-TBNA z u┼╝yciem igie┼é Flex 19G. Wszystkie wykonane rozmazy cytologiczne okaza┼éy si─Ö diagnostyczne (wydolno┼Ť─ç diagnostyczna 100%). Z┼éo┼Ťliwy charakter zmiany stwierdzono w 15 przypadkach (68,2%), natomiast ┼éagodn─ů adenopati─Ö u 7 pacjent├│w (31,8%). W 12 z 14 przypadk├│w raka p┼éuca wykonane CB mog┼éy by─ç u┼╝yte do oznacze┼ä immunohistochemicznych i molekularnych. Po biopsji w─Öz┼é├│w ch┼éonnych, zw┼éaszcza wn─Ökowych, nie obserwowano nasilonego krwawienia. W por├│wnaniu ze standardow─ů procedur─ů EBUS-TBNA z u┼╝yciem ig┼éy 21/22G endoskopi┼Ťci podkre┼Ťlali wi─Öksz─ů gi─Ötko┼Ť─ç uzbrojonego endoskopu oraz jako┼Ť─ç bioptatu, natomiast w pozosta┼éych aspektach biopsji r├│┼╝nice by┼éy nieznacz─ůce. WNIOSKI: Pierwsze polskie do┼Ťwiadczenia z u┼╝yciem igie┼é Flex 19G okazuj─ů si─Ö by─ç podobne do standardowej techniki z u┼╝yciem igie┼é 21/22G oraz prezentuj─ů wysok─ů wydolno┼Ť─ç diagnostyczn─ů w raku p┼éuca, szczeg├│lnie z zastosowaniem CB. Profil bezpiecze┼ästwa biopsji jest akceptowalny

    Elevated Foxp3/CD8 Ratio in Lung Adenocarcinoma Metastatic Lymph Nodes Resected by Transcervical Extended Mediastinal Lymphadenectomy

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    A balance between tumor invasion and immune defence system is widely investigated. Objective. The aim of this study was to evaluate lymphocyte phenotype in lymph nodes (LNs) of patients with lung cancer in relation to the presence of metastases. Methods. We investigated 364 LNs resected by transcervical extended mediastinal lymphadenectomy (TEMLA) of 49 patients with squamous cell carcinoma (SCC) or adenocarcinoma (AD) with (A) and without metastases (B). Expression of CD4, CD8, CD25, CTLA-4, and Foxp3 was assessed by immunohistochemical staining. Results. We observed a strong nuclear staining for Foxp3 in lymphocytes and cancer cells and strong membranous/cytoplasmatic reaction for CD4 and CD8, but low for CD25 and CTLA-4. There were significantly higher proportions of CD8+ cells in AD (B) versus AD (A) LNs (80% versus 52.5%, p<0.05). The Foxp3/CD8 ratio was higher in AD (A) versus AD (B) LNs (0.4 versus 0.25, p<0.05). No significant differences in the cell markers expression in SCC LNs were found. Conclusion. Significant differences in lymphocyte phenotype in AD may indicate an exceptional biology of this type of lung cancer. TEMLA resected LNs may serve as valuable samples for evaluation of immune status in lung cancer patients

    Multicenter Evaluation of the Idylla GeneFusion in Non-Small-Cell Lung Cancer.

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    Targeted therapy in lung cancer requires the assessment of multiple oncogenic driver alterations, including fusion genes. This retrospective study evaluated the Idylla GeneFusion prototype, an automated and ease-of-use (<2 minutes) test, with a short turnaround time (3 hours) to detect fusions involving ALK, ROS1, RET, and NTRK1/2/3 genes and MET exon 14 skipping. This multicenter study (18 centers) included 313 tissue samples from lung cancer patients with 97 ALK, 44 ROS1, 20 RET, and 5 NTRKs fusions, 32 MET exon 14 skipping, and 115 wild-type samples, previously identified with reference methods (RNA-based next generation sequencing/fluorescence in situ hybridization/quantitative PCR). Valid results were obtained for 306 cases (98%), overall concordance between Idylla and the reference methods was 89% (273/306); overall sensitivity and specificity were 85% (165/193) and 96% (108/113), respectively. Discordances were observed in 28 samples, where Idylla did not detect the alteration identified by the reference methods; and 5 samples where Idylla identified an alteration not detected by the reference methods. All of the ALK-, ROS1-, and RET-specific fusions and MET exon 14 skipping identified by Idylla GeneFusion were confirmed by reference method. To conclude, Idylla GeneFusion is a clinically valuable test that does not require a specific infrastructure, allowing a rapid result. The absence of alteration or the detection of expression imbalance only requires additional testing by orthogonal methods

    Multicenter Evaluation of the Idylla GeneFusion in Non-Small-Cell Lung Cancer

    No full text
    Targeted therapy in lung cancer requires the assessment of multiple oncogenic driver alterations, including fusion genes. This retrospective study evaluated the Idylla GeneFusion prototype, an automated and ease-of-use (<2 minutes) test, with a short turnaround time (3 hours) to detect fusions involving ALK, ROS1, RET, and NTRK1/2/3 genes and MET exon 14 skipping. This multicenter study (18 centers) included 313 tissue samples from lung cancer patients with 97 ALK, 44 ROS1, 20 RET, and 5 NTRKs fusions, 32 MET exon 14 skipping, and 115 wild-type samples, previously identified with reference methods (RNA-based next generation sequencing/fluorescence in situ hybridization/quantitative PCR). Valid results were obtained for 306 cases (98%), overall concordance between Idylla and the reference methods was 89% (273/306); overall sensitivity and specificity were 85% (165/193) and 96% (108/113), respectively. Discordances were observed in 28 samples, where Idylla did not detect the alteration identified by the reference methods; and 5 samples where Idylla identified an alteration not detected by the reference methods. All of the ALK-, ROS1-, and RET-specific fusions and MET exon 14 skipping identified by Idylla GeneFusion were confirmed by reference method. To conclude, Idylla GeneFusion is a clinically valuable test that does not require a specific infrastructure, allowing a rapid result. The absence of alteration or the detection of expression imbalance only requires additional testing by orthogonal methods
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