Application and clinical significance of ultrasonography guided core needle biopsy of supraclavicular lymphnode for diagnosis and molecular genetic testing of advanced lung cancer

Abstract

Objective To evaluation the application and safety of ultrasonography (US) -guided core needle biopsy (CNB) of supraclavicular lymph node for diagnosis and the molecular genetic testing of advanced lung cancer. Methods The clinical data of 178 lung cancer patients who underwent US-guided CNB of supraclavicular lymph node from March 2013 to May 2015 were retrospectively analyzed. Results The accuracy of US-guided CNB of supraclavicular lymph node diagnosing was 96.1%(171/178). The cutoff value of the short-axis dimension of supraclavicular lymph node on US was 9.75 mm, the sensitivity was 88.8%, and the specificity was 88.9%. There were significant differences between positive metastasis group and negative metastasis group in losing or deviating of a central hilar structure, lower echogenicity of cortex and RI (P<0.05). The rate of EGFR mutation positive and ALK positive in lung adenocarcinoma was 36.5% and 2.9% respectively. There was no operation-related complication of US-guided CNB of supraclavicular lymph node. Conclusions US-guided CNB of supraclavicular lymph node is a reliable method for diagnosing metastasis, histologic subtyping, and molecular genetic testing in lung cancer. It may gradually replace invasive lung biopsy. Key words: Ultrasonography-guided; Supraclavicular lymph node; Biopsy; Lung cancer; EGFR mutation; Anaplastic lymphoma kinase