Endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer diagnosis and staging

Abstract

Lung cancer is one of the most prevalent types of cancer in the world. A complete diagnosis of lung cancer involves tissue acquisition for pathological subtype, molecular diagnosis and accurate staging of the disease to guide appropriate therapy. Real-time endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is minimally invasive and relatively safe procedure, which can be done on an outpatient basis under moderate sedation. EBUS-TBNA has been shown to be a safe modality to obtain tissue for diagnosis, staging and molecular profiling in lung cancer. EBUS-TBNA stands out in comparison with other modalities for tissue acquisition in lung cancer. EBUS-TBNA performed with the patient under moderate sedation yields sufficient tissue for sequential molecular analysis in most patients. In this review, we describe the role of EBUS-TBNA in various aspects of diagnosis and staging of lung cancer in the present era along with its future aspects.

Keywords:

• CP-EBUS
• diagnosis
• EBUS-TBNA
• endobronchial ultrasound
• lung cancer
• molecular analysis
• re-staging
• staging
• technical aspects

Financial & competing interests disclosure

K Yasufuku has received research and educational support from Olympus Medical systems Corp. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Lung cancer remains the commonest cause of cancer deaths worldwide in both males and females.

• Endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) can diagnose and stage lung cancer accurately and safely in the same setting. However, a negative result on EBUS-TBNA sample may be required to confirm surgically.

• EBUS-TBNA stands out in comparison with other modalities for tissue acquisition in lung cancer.

• EBUS-TBNA accurately restages disease in anatomically distorted previously treated patients with lung cancer.

• EBUS-TBNA samples allow complete cytological and molecular profiling of lung cancer with high accuracy.