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Performance of Endobronchial Ultrasound-Guided Cryobiopsy in Diagnosing Thoracic Disorders and Its Role in Next-Generation Sequencing for Non-Small-Cell Lung Cancer.

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  • Additional Information
    • Source:
      Publisher: Wiley Country of Publication: United States NLM ID: 101558762 Publication Model: eCollection Cited Medium: Internet ISSN: 2090-1844 (Electronic) Linking ISSN: 20901844 NLM ISO Abbreviation: Pulm Med Subsets: MEDLINE
    • Publication Information:
      Publication: 2024- : [Hoboken, NJ] : Wiley
      Original Publication: Cairo : Hindawi Pub. Corp.
    • Subject Terms:
      Carcinoma, Non-Small-Cell Lung*/pathology ; Carcinoma, Non-Small-Cell Lung*/diagnosis ; Lung Neoplasms*/pathology ; Lung Neoplasms*/diagnosis ; Endoscopic Ultrasound-Guided Fine Needle Aspiration*/methods ; Bronchoscopy*/methods; Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Aged ; High-Throughput Nucleotide Sequencing/methods ; Adult ; Aged, 80 and over
    • Abstract:
      Competing Interests: Dr. Sze Shyang Kho has received a travel grant from ERBE Elektromedizin GmbH. Dr. Chun Ian Soo has received speaker honoraria from Cook Medical. All other authors have no conflict of interest.
      Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an established procedure for diagnosing thoracic diseases and staging of lung cancers. However, some limitations of cytology specimens from EBUS-TBNA include small sample size, low tumour cellularity, necrosis and specimen contamination. Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (EBUS-TBMC) is a promising alternative that provides a larger histology specimen which may improve diagnostic accuracy and molecular testing. This study is aimed at evaluating the benefits of EBUS-TBMC over EBUS-TBNA, focusing on improving next-generation sequencing (NGS) success rates, and assessing its efficacy and safety in a real-world setting. Methods: Data from 203 patients (99 underwent EBUS-TBNA and 104 underwent EBUS-TBMC) were retrospectively traced and analysed using descriptive statistics. Results: The overall diagnostic yield was significantly higher for EBUS-TBMC (90.38%) than that for EBUS-TBNA (67.68%; p < 0.001). For heterogeneous lesions, the diagnostic yield was 92.31% for EBUS-TBMC and 69.44% for EBUS-TBNA ( p = 0.011). For non-small-cell lung cancer (NSCLC), EBUS-TBMC specimens demonstrated higher overall tumour cellularity (65% vs. 30%; p < 0.001) and better success in detecting driver alterations through NGS (85.36% vs. 61.90%; p = 0.035). The median procedure duration was shorter for EBUS-TBMC (22 vs. 32 min; p < 0.001), and the complication rates were comparable between the two techniques. These findings suggest that EBUS-TBMC offers additional diagnostic advantages over EBUS-TBNA for heterogeneous lesions and significantly facilitates the acquisition of cell-rich specimens for NGS testing. Conclusion: EBUS-TBMC increases the overall diagnostic yield of mediastinal diseases. EBUS-TBMC provides cell-rich histology specimens with high tumour content, facilitating NGS testing in the management of NSCLC.
      (Copyright © 2025 Chun Ian Soo et al. Pulmonary Medicine published by John Wiley & Sons Ltd.)
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    • Publication Date:
      Date Created: 20250908 Date Completed: 20250908 Latest Revision: 20250910
    • Publication Date:
      20250910
    • Accession Number:
      PMC12411052
    • Accession Number:
      10.1155/pm/3522554
    • Accession Number:
      40918753