Tissue is the issue: Endobronchial Ultrasonography and EBUS-TBNA

Direct real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) using the convex probe endobronchial ultrasound (CP-EBUS) is a relatively new minimally-invasive and accurate technique for preoperative staging of NSCLC patients. Tissues obtained by EBUS-TBNA allow further analyses to be carried out and may help directing NSCLC patients to molecularely-based different therapies. The objective for this work was to investigate the feasibility of EBUS-TBNA for obtaining nodal tissue samples that can be utilized for IHC analysis. Patients with pN2-NSCLC were enrolled. Mediastinal LN specimens obtained by EBUS-TBNA in those patients underwent IHC staining for the expression of 6 cell cycle-related proteins (pRb cyclin D1 p16 p53 p21 and Ki-67). Results revealed that immunohistochemical staining was feasible in all mediastinal nodal tissue samples. All the examined cases showed an abnormal expression of at least one of the studied 6 cell cycle proteins. In conclusion EBUS-TBNA is an effective tool not only for staging of LC but also for obtaining mediastinal nodal tissue samples amenable for further evaluation.