The aim of the current study was to examine the clinical application of BWF samples in detecting epidermal growth factor receptor (EGFR) mutations in a large sample set of NSCLC patients.
In diagnostic bronchoscopic examinations, before or after biopsy to target lesions, subsequent bronchial washing by saline was performed. Thereafter, EGFR mutation testing for both supernatant and sediment of BWF and histologic tissues was performed via amplification refractory mutation system real-time PCR (ARMS RT-PCR) assay.
A total of 127 cases of histologic and corresponding BWF samples of patients underwent bronchoscopy for suspected lung malignant tumor lesions on chest radiography were successfully obtained. Of these, 72 cases were pathologically confirmed to be NSCLC based on forceps biopsy samples and EGFR mutations were identified in 26 cases. In 70 of 72 cases, the results of EGFR mutation status were concordant for BWF and histologic samples, and the concordance rate was 97%. In 13 cases that were not pathologically diagnosed with NSCLC with forceps biopsy samples but other samples, five cases (38.46%) with EGFR mutated-type were detected by BWF. The overall EGFR mutation concordance rate between supernatant and sediment specimens was 100%. The detection of EGFR mutations with supernatant/sediment of BWF samples showed a sensitivity of 86.5%, a specificity of 100%.
This study demonstrates a clear comparison of supernatant/sediment of BWF samples and histologic tissues for EGFR mutation testing with largest clinical samples to date. Both supernatant and sediment of BWF samples showed high credibility and concordance via highly sensitive PCR analysis. BWF is considered a simple, rapid and effective alternative for histologic samples in EGFR mutation testing.
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All authors have declared no conflicts of interest.