Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer and mediastinal lesions / 复旦学报（医学版）

Objective To investigate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in lung carcinoma and mediastinal lesions.Methods From Jan.,2015 to Dec.,2015,368 patients with hilar and/or mediastinal lymphadenopathy or mass outside the airways by CT scan or PET/CT in Department of Pulmonary Medicine,Zhongshan Hospital,Fudan University were enrolled and recieved EBUS-TBNA examination.All of their clinical data were collected.Results Retrospective analysis was performed in the 368 patients.In the 252 patients diagnosed as malignancy,232 patients were diagnosed by EBUS-TBNA,while the other 116 patients were diagnosed as benign disease.The diagnostic concordance rate was 92.9 ％.A total of 387 lymph nodes and 56 masses outside the airways were found among the 368 patients received EBUS-TBNA procedure.The sensitivity and specificity of EBUS-TBNA were 92.1 ％ and 100 ％,respectively.Conclusions EBUS-TBNA is an effective and safe method with high specificity and sensitivity in diagnosis of unknown hilar and/or mediastinal lymphadenopathy,mediastinal mass as well as lymph node staging in lung cancer patients.

Monitoring EGFR T790M mutations by Blocker PCR in plasma of advanced non-small-cell lung cancer patients with EGFR-TKI acquired resistance / 复旦学报（医学版）

Objective To evaluate the feasibility of Blocker PCR assays in monitoring T790M mutations in plasma of non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) acquired resistance.Methods Blocker PCR assays were employed to identify mutations in plasma for 127 advanced NSCLC with acquired EGFR-TKI resistance.In addition,the paired tumor re-biopsy or PE samples were obtained to analyze EGFR mutations.Meanwhile,we evaluated the detection accuracy of Blocker PCR assays in comparison with the next generation sequencing (NGS).Results Among the 127 patients,40.15％ (51/127) EGFR T790M was detected in the plasma,78.44％ (40/51) coexisted with an EGFR activating mutation.Additionally,54.54 ％ (6/11) EGFR T790M was identified in re-biopsy tissues,while 43.75 ％ (14/32) were detected in the plasma.Furthermore,the concordance rate of Blocker PCR and NGS in identifying EGFR sensitizing mutations and EGFR T790M mutations was 100％.Conclusions Blocker PCR is a highly sensitive and reliable method in monitoring EGFR T790M mutations in the plasma of NSCLC patients with EGFR-TKI acquired resistance.