[The role of endoscopic ultrasound-guided transesophageal fine needle aspiration and immunocytochemistry assesment of the patients with suspected lung cancer and negative bronchoscopic biopsies].
BACKGROUND
Endoscopic ultrasound-(EUS) guided fine needle aspiration (FNA) allows the assessment of the posterior mediastinum, as well as the diagnosis and staging of lung cancer patients. The purpose of this feasibility study was to assess the importance of EUS-FNA combined with cytology and immunocytochemistry for patients with suspected lung cancer and negative bronchoscopic biopsies.


METHODS
Our study included 20 consecutive patients assessed at the Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova. The patients were initially examined by chest X-ray, computer tomography scans and bronchoscopy, without a tissue confirmation of malignancy.


CONCLUSIONS
Of the 20 patients included in our study without a tissue confirmation of malignancy, 16 patients had a positive EUS-FNA for malignancy. For 11 patients the samples were obtained from the mediastinal lymphnodes, and for 4 cases directly from the primary mediastinal tumor, some of the obtained samples being included in paraffin to obtain cell blocks. The cell blocks allowed us to accomplish imunocytochemistry for two purposes: to establish the epithelial and mesenchimal fenotype of the malignant cells, as well as the origin of the identified atypical cells.


CONCLUSIONS
EUS-FNA combined with cytology, is an excellent minimal invasive technique, highly accurate for the assessment of lung cancer, showing not only the tumoral and lymph node invasion, but also offering the ideal alternative for surgical staging. Association of immunocytochemistry determined an increase in the accuracy of the method, as well as the confirmation of a tissue diagnosis of malignancy.
Ioncică
Ana Maria
AM
Centrul de Cercetare în Gastroenterologie şi Hepatologie Craiova, Universitatea de Medicină şi Farmacie din Craiova, România.
Popescu
Carmen
C
Maloş
Anca
A
Ioncică
Lucian
L
Filip
Monalisa
M
Iordache
Sevastiţa
S
Săndulescu
Larisa
L
Gheonea
Dan Ionuţ
DI
Ciurea
Tudorel
T
Neagoe
Daniela
D
Săftoiu
Adrian
A
D044963:Biopsy, Fine-Needle; D019160:Endosonography / Q000295:instrumentation* / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity