title: Use of CT-guided fine needle aspiration biopsy in epidermal growth factor receptor mutation analysis in patients with advanced lung cancer.
abstract: BACKGROUND
  The safety of using a cutting needle when performing a core-needle biopsy is of major concern, in particular for small lung tumors or tumors near the hilum.
  
  
  OBJECTIVE
  To investigate the usefulness of CT-guided fine needle aspiration biopsy (FNAB) of the lung in obtaining tumor tissue for epidermal growth factor receptor (EGFR) mutation analysis in advanced lung cancer patients.
  
  
  METHODS
  Forty-three patients with stage IIIB-IV lung cancer were enrolled. In all patients, CT-guided FNAB was performed using an 18-gauge or 20-gauge Chiba aspiration needle for histology diagnosis and EGFR mutation analysis. Complications associated with CT-guided FNAB were observed, and the specimen mutational assessments were recorded.
  
  
  RESULTS
  The obtained tumor samples ranged from 0.5-1.5 cm in length and were adequate for histological and DNA analyses in all patients. No patient had a pneumothorax or hemoptysis. Minor needle tract bleeding appeared in eight patients. Mutation analysis was satisfactorily demonstrated in 23 mutations and 20 non-mutations. Ten and 13 mutations were identified by 18-gauge and 20-gauge needle biopsies, respectively. EFGR mutations, including 12 cases of EGFR exon 19 deletion and 11 cases of exon 21 point mutation, were present in 21 patients with adenocarcinomas, one with squamous cell carcinoma, and one with undifferentiated carcinoma.
  
  
  CONCLUSIONS
  CT-guided FNAB is a feasible and safe technique for obtaining lung tumor tissues for EGFR gene mutation analysis.
authors: Department of Radiology, Jiangsu Cancer Institute and Hospital, Nanjing, China. yipingzhuang2010@sina.com
authors: Yi-Ping
authors: YP
authors: Zhuang
authors: Hai-Yan
authors: HY
authors: Wang
authors: Mei-Qi
authors: MQ
authors: Shi
authors: Jin
authors: J
authors: Zhang
authors: Yong
authors: Y
authors: Feng
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000235:genetics* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology; D066246:ErbB Receptors / Q000235:genetics*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D066246:ErbB Receptors