title: Transbronchial biopsy needle rinse solution used for comprehensive biomarker testing in patients with lung cancer.
abstract: BACKGROUND
  Although genetic information is essential for molecular targeted therapy for personalized medicine, tissue sampling for genetic analysis remains challenging. We investigated the utility of bronchoscopic sampling in non-small-cell lung cancer (NSCLC) patients compared with conventional histological materials for multiple genetic analyses.
  
  
  METHODS
  Patients with NSCLC proven by onsite cytological evaluation during bronchoscopic survey were eligible for this study. After conventional needle aspiration biopsy by flexible bronchofiberscopy of primary lesions or convex-probe endobronchial ultrasound of lymph nodes, the used needle was rinsed with saline, and the ultra-microsample (uMS) was used for cytological diagnosis and genetic analysis. Gene mutations and fusion genes were examined by high-resolution melting analysis and direct sequencing. The results from the uMS and those from conventional histological samples were compared.
  
  
  RESULTS
  A total of 134 lesions (48 primary and 86 metastatic) were analyzed. Adenocarcinoma (n = 80), squamous-cell carcinoma (n = 43), and NSCLC (n = 11) samples were pathologically confirmed in histological cores; however, malignancies were detected in only 45 (34%) of the corresponding uMS. In 62 samples, genetic disorders, including epidermal growth factor receptor (n = 21), K-ras (n = 11), and BRAF mutations (n = 1); anaplastic lymphoma kinase (n = 5), receptor tyrosine kinase (n = 1), and RET fusion genes (n = 1); and silent mutations (n = 22), were identified. In total, 1474 molecular tests were performed, and 1464 tests (99.3%) were identical for both histological samples and uMS.
  
  
  CONCLUSIONS
  Bronchoscopic uMS (biopsy needle rinsed fluids) are useful for multiple genetic examinations in NSCLC.
authors.affiliation: Departments of *General Thoracic Surgery, §Medical Oncology, Chiba University Graduate School of Medicine, Chiba, Japan; and †Division of Laboratory Medicine and Clinical Genetics and ‡Department of Endoscopic Diagnostics and Therapeutics, Chiba University Hospital, Chiba, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sakairi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sato
authors.forename: Sakae
authors.initials: S
authors.lastname: Itoga
authors.forename: Fumie
authors.initials: F
authors.lastname: Saegusa
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Matsushita
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakajima
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yoshida
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takiguchi
authors.forename: Fumio
authors.initials: F
authors.lastname: Nomura
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics*; D044963:Biopsy, Fine-Needle; D001980:Bronchi / Q000473:pathology*; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D019160:Endosonography; D005260:Female; D050939:Gene Fusion; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012996:Solutions
chemical_list: D014408:Biomarkers, Tumor; D012996:Solutions