OUTCOMES OF ATYPICAL CELLS ON BRONCHOSCOPY FOR MALIGNANCY

Abstract

SESSION TITLE: Wednesday Electronic Posters 3 SESSION TYPE: Original Inv Poster Discussion PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Inconclusive bronchoscopy results occur approximately 40-60% for the evaluation of pulmonary nodules. Very little has been reported on the outcomes of inconclusive bronchoscopy and even less on atypical cell results leaving clinicians in a potential clinical dilemma. It is unclear what the risk of malignancy with atypical cell results is after bronchoscopy. METHODS: A retrospective review of cases with atypical cells from an inconclusive bronchoscopy was examined from the Percepta bronchial genomic classifier multi-center registry. The registry examined inconclusive bronchoscopy results for the evaluation of pulmonary nodules. We collected data on demographics, radiographic characteristics, and pre-test risk assessment for malignancy. All patients had a minimum of 12 month follow-up and adjudication of pathology and imaging. RESULTS: 520 patients enrolled in the PERCEPTA registry with an inconclusive bronchoscopy. 58 (11%) cases were identified with atypical cells on cytology across 18 different medical centers. Of the 58 cases, 17 patients were removed due to lack of follow-up or ineligible for adjudication. Overall, there was a 76% rate of malignancy (OR 5.6, CI 1.19-26.58). In the high risk group (n=18), 94% were eventually found to have malignancy (OR 10.9, CI 1.23-97.04). 62% in the intermediate group (n=35) had malignancy. The low risk group (n=2), 50% had malignancy. CONCLUSIONS: Atypical cells on bronchoscopy may increase the post-test risk of malignancy especially in the high risk group. CLINICAL IMPLICATIONS: Atypical cells on bronchoscopy has not been examined in the United States to our knowledge. Our cohort reports 11% prevalence in a multi-center registry. The findings of atypical cells increases the risk of malignancy especially in the high risk group where it is 94%, consideration should be made to forego additional diagnostic testing if surgery or curative radiation is a potential option. DISCLOSURES: No relevant relationships by Alexa Barriere, source=Web Response Consultant relationship with AstraZeneca Please note: $5001 - $20000 Added 11/29/2018 by David Feller-Kopman, source=Web Response, value=Consulting fee Consultant relationship with Veracyte Please note: $5001 - $20000 Added 11/29/2018 by David Feller-Kopman, source=Web Response, value=Consulting fee Consultant relationship with Veran Medical Please note: $5001 - $20000 Added 11/29/2018 by David Feller-Kopman, source=Web Response, value=Consulting fee Employee relationship with Veracyte, Inc. Please note: $20001 - $100000 Added 03/15/2019 by Bailey Griscom, source=Web Response, value=Salary Consultant relationship with Veracyte Please note: $5001 - $20000 Added 03/18/2019 by Hans Lee, source=Web Response, value=Consulting fee Consultant relationship with Veran medical Please note: $5001 - $20000 Added 03/18/2019 by Hans Lee, source=Web Response, value=Consulting fee Employee relationship with Veracyte Please note: >$100000 Added 03/15/2019 by Lori Lofaro, source=Web Response, value=Salary No relevant relationships by Christopher Mallow, source=Web Response No relevant relationships by Majid Shafiq, source=Web Response No relevant relationships by Jeffrey Thiboutot, source=Web Response Consultant relationship with Veran Please note: >$100000 Added 11/29/2018 by Lonny Yarmus, source=Web Response, value=Grant/Research Support Research relationship with Rocket Medical Please note: $20001 - $100000 Added 06/20/2019 by Lonny Yarmus, source=Web Response, value=Grant/Research