title: Adequacy of core needle biopsy specimens and fine-needle aspirates for molecular testing of lung adenocarcinomas.
abstract: OBJECTIVE
  Molecular testing of lung adenocarcinomas for epidermal growth factor (EGFR) mutations and an anaplastic lymphoma kinase (ALK) translocation is important to guide directed therapy with tyrosine kinase inhibitors. The goal of this study was to determine whether transthoracic computed tomography-guided core needle biopsy (CNB) and fine-needle aspiration (FNA) biopsy specimens were equally suitable for molecular testing.
  
  
  METHODS
  We determined the percentage of 52 CNB and 120 FNA specimens that contained sufficient paraffin-embedded tumor tissue for EGFR, KRAS, and ALK testing over a period of 2 years. We correlated sample sufficiency with the sampling method, tumor size, biopsy operator, pathologist assessing the adequacy of the sample, and the number of FNA passes performed.
  
  
  RESULTS
  Univariate analysis showed that CNB specimens provided a significantly higher number of samples sufficient for molecular testing than did FNA specimens (67% vs 46%; P = .007) and that one operator achieved a significantly higher percentage of sufficient FNA specimens. Binomial logistic regression found sufficiency of FNA samples to correlate with tumor size (P = .015) but not operator.
  
  
  CONCLUSIONS
  When paraffin-embedded tissue is used for molecular testing of lung cancer, CNB specimens are more likely than FNA specimens to provide adequate tissue for molecular testing. Obtaining a sufficient FNA specimen depends on the tumor size and the individual performing the biopsy.
authors.affiliation: From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA. schneiderf@upmc.edu.
authors.forename: Frank
authors.initials: F
authors.lastname: Schneider
authors.affiliation: From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Smith
authors.affiliation: From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Molly C
authors.initials: MC
authors.lastname: Lane
authors.affiliation: From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Liron
authors.initials: L
authors.lastname: Pantanowitz
authors.affiliation: From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Sanja
authors.initials: S
authors.lastname: Dacic
authors.affiliation: From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: N Paul
authors.initials: NP
authors.lastname: Ohori
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D044963:Biopsy, Fine-Needle / Q000592:standards; D062005:Biopsy, Large-Core Needle / Q000592:standards; D003581:Cytodiagnosis / Q000379:methods / Q000592:standards; D066246:ErbB Receptors / Q000032:analysis / Q000235:genetics; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D010340:Pathology, Surgical / Q000379:methods* / Q000592:standards; D016133:Polymerase Chain Reaction; D011518:Proto-Oncogene Proteins / Q000032:analysis / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins / Q000032:analysis / Q000235:genetics
chemical_list: C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; C512478:EGFR protein, human; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins
keywords: Adenocarcinoma; Adequacy; Core needle biopsy; Fine-needle aspiration; Lung cancer; Molecular testing