General Thoracic and Cardiovascular Surgery

, Volume 61, Issue 7, pp 390–396

Current status and perspective of EBUS-TBNA

Authors

    • Department of General Thoracic Surgery, Graduate School of MedicineChiba University
    • Division of Thoracic Surgery, Toronto General Hospital, University Health NetworkUniversity of Toronto
  • Kazuhiro Yasufuku
    • Division of Thoracic Surgery, Toronto General Hospital, University Health NetworkUniversity of Toronto
  • Ichiro Yoshino
    • Department of General Thoracic Surgery, Graduate School of MedicineChiba University
Current Topics Review Article

DOI: 10.1007/s11748-013-0224-6

Cite this article as:
Nakajima, T., Yasufuku, K. & Yoshino, I. Gen Thorac Cardiovasc Surg (2013) 61: 390. doi:10.1007/s11748-013-0224-6

Abstract

In 2002, a new bronchoscope equipped with a convex type ultrasound probe on the tip was introduced into clinical practice. This convex probe endobronchial ultrasound (CP-EBUS) provides a long axis image of surrounding structures of the major airway. The CP-EBUS combined with a dedicated biopsy needle allows real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of mediastinal and hilar lymph nodes. Samples obtained from EBUS-TBNA can be used for pathological diagnosis including immunohistochemistry. EBUS-TBNA is now being performed worldwide for several indications including mediastinal staging, mediastinal pathology and for benign diseases. For mediastinal staging in lung cancer, the diagnostic yield of EBUS-TBNA is comparable to surgical staging in patients with enlarged lymph nodes. In addition, EBUS-TBNA can be used for molecular analysis of tumor cells obtained during the procedure. DNA mutation testing using EBUS-TBNA samples was first reported in 2007 for a chondrosarcoma case. Also, isolated DNA from EBUS-TBNA samples was applied for epidermal growth factor receptor mutation testing and aberrant methylation analysis in patients with lung cancer. RNA was also isolated from properly stored EBUS-TBNA samples and used for gene expression research and aberrant fusion gene detection in lung cancer patients. Optimization of tissue banking methods of EBUS-TBNA specimens was also investigated. Currently, EBUS-TBNA samples can be used for comprehensive mRNA and miRNA expression analysis. EBUS-TBNA will become an important modality for bronchoscopists in the era of personalized medicine in lung cancer.

Keywords

Endobronchial ultrasoundTransbronchial biopsyLung cancerBiomarkerTranslational research

Copyright information

© The Japanese Association for Thoracic Surgery 2013