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Current status and perspective of EBUS-TBNA

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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.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Takahiro Nakajima & Ichiro Yoshino

  2. Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, 200 Elizabeth street, Toronto, Ontario, Canada

    Takahiro Nakajima & Kazuhiro Yasufuku

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  1. Takahiro Nakajima
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  2. Kazuhiro Yasufuku
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  3. Ichiro Yoshino
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Correspondence to Takahiro Nakajima.

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The review was submitted at the invitation of the editorial committee.

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Nakajima, T., Yasufuku, K. & Yoshino, I. Current status and perspective of EBUS-TBNA. Gen Thorac Cardiovasc Surg 61, 390–396 (2013). https://doi.org/10.1007/s11748-013-0224-6

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