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Sang Hoon Lee
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P1.09 - Pathology (ID 173)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.09-14 - Comparison Between Liquid Biopsy and Conventional Tissue Biopsy in EGFR Genotyping of Non-Small Cell Lung Cancer (ID 978)
09:45 - 18:00 | Presenting Author(s): Sang Hoon Lee
- Abstract
Background
In lung cancer, tissue biopsy is usually invasive and could provoke a severe procedural complication depending on the location and size, while liquid biopsy is non-invasive, and novel emerging method in lung cancer. In this study, we investigated the sensitivity, specificity, and concordance rate of liquid biopsy (blood and bronchoalveolar lavage fluid (BALF)) comparing with tissue biopsy.
Method
A total of 31 patients’ tissue, blood, and BALF were available. The EGFR mutation status in blood, and BALF were investigated by ultrasensitive droplet-digital polymerase chain reaction (ddPCR) method. We applied two QC criteria for the results of ddPCR were used as previous study showed: 1) the droplet number must be greater than 9000; 2) the wild type levels to be greater than 100 copies/mL.
Result
Female was 15 (48.4%) and mean age was 66.4 ± 9.6. Clinical sensitivity was 20.0% [2/10] for E19del and 36.4% [4/11] for L858R in plasma, while in BALF, those was 70.0% and 81.8%, respectively. The concordance rates of plasma with tissue-based results of EGFR mutations were 71.0% for E19del and 77.4% for L858R. In BALF, those were 83.9% for E19del, and 90.3% for L858R. The area under the curve (AUC) for E19del was 0.576 in blood and 0.802 in BALF. The AUC for L858R was 0.682 in blood and 0.884 in BALF. The values of AUC between blood and BAL did not show significant difference.
Conclusion
BALF could be a substitute for biopsy in EGFR genotyping and BALF might be helpful in diagnosis of lung cancer in situations where it is difficult to perform biopsy or rebiopsy is needed. Further prospective large scaled studies are needed to investigate the utility of BAL in lung cancer.
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P2.05 - Interventional Diagnostic/Pulmonology (ID 168)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Interventional Diagnostics/Pulmonology
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.05-16 - Diagnostic Value of Concomitant Use of Radial Probe Endobronchial Ultrasound with Guide Sheath and Transbronchial Biopsy in Lung Cancer (ID 313)
10:15 - 18:15 | Author(s): Sang Hoon Lee
- Abstract
Background
Although using radial endobronchial ultrasound with guide sheath (r-EBUS-GS) has shown its diagnostic power in peripheral pulmonary lesion, its actual utility is still low due to variable diagnostic performance. To overcome its limitation, we evaluated the feasibility and efficacy of r-EBUS-GS when combined with transbronchial biopsy (TBB).
Method
We retrospectively reviewed the medical records of 74 patients with NSCLC who underwent r-EBUS-GS plus TBB or TBB alone as diagnostic methods between 2017 Aug. and 2018 Nov. at the Severance hospital. Subjects were grouped by diagnostic modalities used (r-EBUS-GS plus TBB vs. TBB alone). Each group was matched by age, sex, biopsy location. Chi-square analysis and paired-t test were used to compare the characteristics, and to find the factors which affect to the diagnostic yield.
Result
In each group, the number of male subjects was 21 and their mean age was 67.5 and 67.3, respectively. Lesion size was statistically smaller in r-EBUS-GS group. Although r-EBUS-GS alone (15/37, 40.5%) showed poor diagnostic yield, combination of r-EBUS-GS and TBB (27/37, 72.9%) showed higher than TBB alone group (23/37, 62.1%). Lung lesion with bronchus sign was revealed significant relationship with higher diagnostic yield (p<0.005).
Table 1. Lesion characteristics of each group Lesion characteristics
r-EBUS-GS+TBB
(n=37)
TBB only
(n=37)
P-value
Location
1.000
- RUL
8 (21.6%)
8 (21.6%)
- RML
3 (8.1%)
3 (8.1%)
- RLL
10 (27.0%)
10 (27.0%)
- LUL
11 (29.7%)
11 (29.7%)
- LLL
5 (13.5%)
5 (13.5%)
CT finding
0.193
- Nodule/mass
27 (73.0%)
26 (70.3%)
- Subsolid GGO
9 (24.3%)
6 (16.2%)
- GGO or consolidation
1 (2.7%)
5 (13.5%)
Size
23.6 ± 7.6
34.5 ± 15.5
< 0.001
- < 20
13 (35.1%)
7 (18.9%)
- 20-30
17 (45.9%)
11 (29.7%)
- > 30
7 (18.9%)
19 (51.4%)
Pleural distance
14.8 ± 14.4
10.3 ± 10.5
0.102
ConclusionTable 2. Comparison of diagnostic yield according to biopsy methods Diagnostic yield
r-EBUS-GS+TBB (n=37)
TBB only
(n=37)
r-EBUS-GS only
combined
- Accuracy
15/37 (40.5%)
27/37 (72.9%)
23/37 (62.1%)
Combination of r-EBUS-GS and TBB has higher diagnostic power than using r-EBUS-GS or TBB alone.
