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xun Zhang



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    EP1.01 - Advanced NSCLC (ID 150)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.01-54 - Implementation of Fine Needle Aspiration of Supraclavicular Lymph Node as a Novel Medium for Genomic Profiling in NSCLC (Now Available) (ID 1171)

      08:00 - 18:00  |  Author(s): xun Zhang

      • Abstract
      • Slides

      Background

      Supraclavicular lymph node (SLN) metastasis is not rare in non-small cell lung cancer (NSCLC). Palpation or B-ultrasound guided fine needle aspiration (FNA) of SLN is a very simple, rapid, and minimally invasive tool for diagnosis of these patients. With the development next generation sequencing (NGS) which has been widely used to catalogue genetic mutations in cancer, uncertainty remains if FNA of lymph node could be combined with NGS and applied in clinical practice. The aim of this study was to evaluate the clinical utility of FNA of SLN in patients with NSCLC

      Method

      FNA of SLN samples (stored in 10% neutral buffered formalin) and matched plasma samples from 30 patients with NSCLC were collected. Twenty-three patients (both FNA and plasma samples) were sequenced using a panel covering whole exons and critical introns of 520 cancer-related genes and seven patients (both FNA and plasma samples) were profiled using a panel of 168 lung cancer-related genes.

      Result

      During the procedure of next-generation sequencing library construction, the amount of extracted DNA and qualification percentage of FNA samples (n=30) from lymph nodes were similar to those of punctured lung biopsy samples (n=100, randomly selected from burning Rock database). Comparative analysis of mutation spectrums revealed that mutations were positively identified in 93.3% (28/30) FNA samples and 90.0% (27/30) plasma samples, while mutations of eight well-established lung cancer-related genes (EGFR, ERBB2, MET, BRAF, KRAS, ROS1, ALK and RET) were detected in 83.3% (25/30) FNA samples, which was higher than that in plasma samples (63.3%, 19/30). Moreover, FNA was significantly superior to plasma in detecting copy number variation (CNV) (detection frequencies, 88.9% vs 0.9%, p<0.001), both for CNVs of all genes in NGS panel (99.5% vs 10.0%) and eight well-established genes (96.0% vs 20.0%).

      Conclusion

      Samples from FNA of SLNs were found to be equivalent to plasma during NGS library construction. Moreover, FNA of SLNs was superior to plasma in detecting mutations of eight lung cancer-related genes, as well as CNVs in both all genes of NGS panel and the 8 key genes. This study provides knowledge for the potential use of FNA of lymph nodes in sequencing genomic profiles of patients with lung cancer, and further support its utility in clinical practice.

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