Cancer Research and Treatment

Original Articles

Novel Bronchoscopy Method for Molecular Profiling of Lung Cancer: Targeted Washing Technique: Mi-Hyun Kim, Hayoung Seong, Hyojin Jang, Saerom Kim, Wanho Yoo, Soo Han Kim, Jeongha Mok, Kwangha Lee, Ki Uk Kim, Min Ki Lee, Jung Seop Eom; Received November 25, 2024 Accepted February 25, 2025 Published online February 26, 2025; DOI: https://doi.org/10.4143/crt.2024.1128 [Accepted]

Abstract PDF: Purpose
There have been efforts to find alternative samples other than standard samples of tissue or plasma for mutational analyses for lung cancer patients. However, no other sample or technique has replaced the mutational analyses using standard samples. In this prospective study, we assessed a novel bronchoscopy method, named as targeted washing technique, for detecting the EGFR mutation.
Materials and Methods
A 3.0-mm ultrathin bronchoscope was precisely navigated to the target lung lesion with the assistance of virtual bronchoscopic navigation and fluoroscopy. Once the bronchoscope is placed in front of target lung lesion, 0.9% normal saline was instilled for targeted washing. EGFR testing using targeted washing fluid (TWF) was compared to standard methods using plasma or tumor tissue.
Results
In 41 TWF samples, the T790M mutation was detected in tissue, plasma, and TWF samples at rates of 22%, 10%, and 29%, respectively. The overall EGFR T790M detection rate using tissue, plasma, or TWF samples was 37%, with TWF samples increasing the T790M mutation detection rate by up to 10%. The accuracy of T790M mutation detection using TWF sample was 83% compared with standard samples. Four patients were found to have the EGFR T790M mutation solely through EGFR testing using TWF, which repeated rebiopsies using either plasma or tissue finally confirmed to have the T790M mutation.
Conclusion
We demonstrated the clinical potential of targeted washing technique for molecular testing, which can be a good option to overcome spatial heterogeneity, low sensitivity of plasma sample or technical limitations in collecting tumor tissues.

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Lung and Thoracic cancer

The Additive Impact of Transbronchial Cryobiopsy Using a 1.1-mm Diameter Cryoprobe on Conventional Biopsy for Peripheral Lung Nodules: Soo Han Kim, Jeongha Mok, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee, Jung Seop Eom; Cancer Res Treat. 2023;55(2):506-512. Published online November 1, 2022; DOI: https://doi.org/10.4143/crt.2022.1008

Abstract PDF Supplementary Material PubReader ePub

Purpose
The diagnostic yield of transbronchial biopsy (TBB) using radial probe endobronchial ultrasound (RP-EBUS) is 71%, which is lower than that of transthoracic needle biopsy. We investigated the performance and safety of sequential transbronchial cryobiopsy (TBC) using a novel 1.1-mm diameter cryoprobe, after conventional TBB using RP-EBUS for the diagnosis of peripheral lung lesions (PLLs).
Materials and Methods
From April 2021 to November 2021, 110 patients who underwent bronchoscopy using RP-EBUS for the diagnosis of PLL ≤ 30 mm were retrospectively included in our study. All records were followed until June 2022.
Results
The overall diagnostic yield of combined TBB and TBC was 79.1%, which was higher than 60.9% of TBB alone (p=0.005). The diagnostic yield of sequential TBC was 65.5%, which increased the overall diagnostic yield by 18.2%. The surface area of tissues by TBC (mean area, 18.5 mm²) was significantly larger than those of TBB by 1.5-mm forceps (3.4 mm², p < 0.001) and 1.9-mm forceps (3.7 mm², p=0.011). In the multivariate analysis, PLLs with the longest diameter of ≤ 22 mm were found to be related to additional diagnostic benefits from sequential TBC (odds ratio, 3.51; 95% confidence interval, 1.043 to 11.775; p=0.042). Complications were found in 10.5% of the patients: pneumothorax (1.0%), infection (1.0%), and significant bleeding (8.6%). None of the patients developed any life-threatening complications.
Conclusion
Sequential TBC with a 1.1-mm cryoprobe improved the performance of conventional TBB using RP-EBUS without serious complications.

Citations

Citations to this article as recorded by

Complete resolution of non-tuberculous mycobacterial pulmonary nodule following cryobiopsy: The first case report
Sung Joon Han, Chaeuk Chung, Dongil Park
Diagnostic Pathology.2025;[Epub] CrossRef
Feasibility of a Modified Bronchoscopic Transparenchymal Nodule Access Technique (‘Essen Tunnel’) for Improving the Diagnosis of Intraparenchymal Pulmonary Lesions
Erik Büscher, Faustina Funke, Jane Winantea, Hanna Zellerhoff, Johannes Wienker, Marcel Opitz, Christian Taube, Kaid Darwiche
Respirology.2025;[Epub] CrossRef
Transbronchial lung cryobiopsy for peripheral pulmonary lesions. A narrative review
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Respiratory Research.2024;[Epub] CrossRef
Next‐generation sequencing using tissue specimen collected with a 1.1 mm‐diameter cryoprobe in patients with lung cancer
Mi‐Hyun Kim, Soo Han Kim, Geewon Lee, Jeongha Mok, Min Ki Lee, Ju Sun Song, Jung Seop Eom
Respirology.2024; 29(4): 333. CrossRef
Development of the Korean Association for Lung Cancer Clinical Practice Guidelines: Recommendations on Radial Probe Endobronchial Ultrasound for Diagnosing Lung Cancer - An Updated Meta-Analysis
Soo Han Kim, Hyun Sung Chung, Jinmi Kim, Mi-Hyun Kim, Min Ki Lee, Insu Kim, Jung Seop Eom
Cancer Research and Treatment.2024; 56(2): 464. CrossRef
Navigational bronchoscopy with tranbronchial cryobiopsy in differential diagnosis of peripheral pulmonary lesions
Ya.O. Chesalina, I.Yu. Shabalina, L.A. Semenova, I.V. Sivokozov
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Advanced Bronchoscopic Diagnostic Techniques in Lung Cancer
Dongil Park
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Clinical utility of rapid on-site evaluation of brush cytology during bronchoscopy using endobronchial ultrasound with a guide sheath
Kazuhiro Nishiyama, Kei Morikawa, Shotaro Kaneko, Makoto Nishida, Aya Matsushima, Yoshihiro Nishi, Yu Numata, Yusuke Shinozaki, Hajime Tsuruoka, Hirotaka Kida, Hiroshi Handa, Naoki Shimada, Chie Okawa, Nobuyuki Ohike, Junki Koike, Masamichi Mineshita
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Bronchial branch tracing navigation in ultrathin bronchoscopy-guided radial endobronchial ultrasound for peripheral pulmonary nodule
Sze Shyang Kho, Shirin Hui Tan, Swee Kim Chan, Chan Sin Chai, Siew Teck Tie
BMC Pulmonary Medicine.2024;[Epub] CrossRef
The diagnosis of peripheral lung lesions: transbronchial biopsy using a radial probe endobronchial ultrasound
Jung Seop Eom
Journal of the Korean Medical Association.2023; 66(3): 166. CrossRef
Clinical outcomes of transbronchial cryobiopsy using a 1.1-mm diameter cryoprobe for peripheral lung lesions - A prospective pilot study
Soo Han Kim, Jeongha Mok, Saerom Kim, Wan Ho Yoo, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee, Jung Seop Eom
Respiratory Medicine.2023; 217: 107338. CrossRef

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Metabolic Burden Measured by ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Is a Prognostic Factor in Patients with Small Cell Lung Cancer: Mi-Hyun Kim, Ji Seok Lee, Jeong Ha Mok, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Seong-Jang Kim, Min Ki Lee; Cancer Res Treat. 2014;46(2):165-171. Published online April 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.2.165

Abstract PDF PubReader ePub

Purpose

Evidence regarding the usefulness of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in predicting the prognosis of non-small cell lung cancer is increasing. However, data on small cell lung cancer (SCLC) are scarce. The aim of this study was to evaluate the prognostic value of metabolic parameters measured using ¹⁸F-FDG PET/CT in patients with SCLC.

Materials and Methods

We conducted a retrospective review of 114 patients with pathologically proven SCLC (26 cases of limited disease and 88 cases of extensive disease) who underwent pretreatment ¹⁸F-FDG PET/CT. The maximal SUV (SUV_max) was used quantitatively for determination of FDG PET activity. The SUV_max of the primary tumor (primary SUV_max), the sum of SUV_max values of malignant lesions (SUV_sum), and the mean SUV_max of malignant lesions were calculated.

Results

The patient population was subdivided using a median SUV_sum value of 24.6. High SUV_sum showed a significant association with known factors for poor prognosis, including higher neuron-specific enolase (p=0.010), CYFRA 21-1 (p=0.014), and extensive disease status (p=0.007). Patients with high SUV_sum had significantly shorter median overall survival (6.6 months vs. 13.0 months, p<0.001) and progression-free survival (5.2 months vs. 8.0 months, p<0.001) than patients with low SUV_sum. Results of multivariate analysis showed that SUV_sum, chemotherapy cycles, and the response to first-line treatment were significant prognostic factors of survival. In contrast, mean SUV_max and primary SUV_max were not significant predictors of survival.

Conclusion

In this study, metabolic burden represented by SUV_sum from pretreatment ¹⁸F-FDG PET/CT was an independent prognostic factor in patients with SCLC.

Citations

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Case Report

Sarcoidosis Mimicking Cancer Metastasis Following Chemotherapy for Ovarian Cancer: Mi Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee, Dong Soo Suh; Cancer Res Treat. 2013;45(4):354-358. Published online December 31, 2013; DOI: https://doi.org/10.4143/crt.2013.45.4.354

Abstract PDF PubReader ePub

We report on a rare case of sarcoidosis that developed after chemotherapy for ovarian cancer, and mimicked a cancer metastasis. A 52-year-old female diagnosed with stage III ovarian cancer underwent curative surgery and postoperative chemotherapy. Four months later, her whole-body positron emission tomography and computed tomography (CT) scan showed high uptake in the mediastinal lymph nodes, and ovarian cancer recurrence was suspected. Biopsy of the mediastinal lymph nodes and subcutaneous nodules revealed noncaseating granulomas. These lesions resolved spontaneously without treatment; however, newly developed perilymphatic and centrilobular nodules were observed on follow-up chest CT. Surgical biopsy of these lesions also showed noncaseating granulomas. She was finally diagnosed with sarcoidosis.

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