title: Contribution of ultrasound-guided fine-needle aspiration cell blocks of metastatic supraclavicular lymph nodes to the diagnosis of lung cancer.
abstract: OBJECTIVE
  Routine smears of fine-needle aspiration (FNA) specimens of supraclavicular lymph nodes with ultrasound (US) real-time guidance have proven useful in lung cancer staging, but the clinical value of additional information from cell-block of FNA samples has been little researched. This study mainly focused on the contribution of cell block analysis to the diagnosis and staging in lung cancer.
  
  
  METHODS
  Clinical data about 211 lung cancer patients with supraclavicular lymph node enlargement admitted to ultrasonography in the Zhejiang Cancer Hospital and recommended a needle biopsy under US-guided, the adequacy of the specimens for preparing cell blocks was acquireded, and the additional immunohistochemistry or genetic information provided from cell block analysis was examined.
  
  
  RESULTS
  In 211 lung cancer patients referred for US-guided FNA (median age 61.8 ± 10.0 years, range 30-88) 279 aspirations were performed. Conventional smears could be obtained from 185 aspirates (66.3%) and contained 176 (95.1%) diagnostic smears. Cell blocks could be obtained from 94 aspirates (33.7%) and contained diagnostic material in 88 (93.6%) aspirates. Above all, cell blocks also made epithelial growth factor receptor gene mutation analysis in 17 patients with FNA samples, and the positive rate was 70.6%. Overall, cell blocks provided clinically significant information for 51 of the 211 patients participating in the study (24.2%).
  
  
  CONCLUSIONS
  Cell-block samples from US-guided FNA is a promising, relatively noninvasive technique to provide additional information in lung cancer diagnosis. Analysis of cell blocks allows for genetic analysis of the patients with supraclavicular lymph nodes metastasis.
authors.forename: Hai-Ying
authors.initials: HY
authors.lastname: Tian
authors.affiliation: Department of Ultrasonography, Zhejiang Cancer Hospital, Hangzhou, 310022, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Xu
authors.forename: Jun-Ping
authors.initials: JP
authors.lastname: Liu
authors.affiliation: Department of Thoracic Oncology Surgery, Zhejiang Cancer Hospital, Hangzhou, 310022, China.
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Mao
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Chen
authors.forename: Chen
authors.initials: C
authors.lastname: Yang
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Wang
authors.forename: Kai-Yuan
authors.initials: KY
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000556:secondary*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography