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Accuracy of transbronchial biopsy as a rebiopsy method for patients with relapse of advanced non-small-cell lung cancer after systemic chemotherapy
  1. Hidenobu Ishii,
  2. Koichi Azuma,
  3. Kazuhiko Yamada,
  4. Norikazu Matsuo,
  5. Masayuki Nakamura,
  6. Takaaki Tokito,
  7. Takashi Kinoshita and
  8. Tomoaki Hoshino
  1. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
  1. Correspondence to Dr Koichi Azuma; azuma{at}


Introduction Rebiopsy in patients with advanced non-small-cell lung cancer (NSCLC) resistant to systemic chemotherapy may yield information on the mechanisms of resistance and planning of subsequent treatment. Transbronchial biopsy (TBB) using a flexible bronchoscope has been commonly used for establishing the initial diagnosis of lung cancer. The aim of this study was to assess the accuracy and safety of TBB in patients with NSCLC relapse, and the factors affecting its diagnostic yield.

Methods We retrospectively screened patients with advanced NSCLC who underwent TBB for rebiopsy after developing resistance to systemic chemotherapy at Kurume University Hospital between January 2012 and June 2016. A positive diagnostic result obtained by TBB was defined as malignancy determined on the basis of histological features that were adequate for mutational analysis or immunohistochemistry. Severe postprocedural complications were defined as those requiring invasive medical procedures or prolonged hospitalisation.

Results 109 patients were enrolled in this retrospective study. Adequate tumour samples were collected from 88 of these patients, giving a high diagnostic yield of 80.7%. The diagnostic yield of TBB was not associated with tumour mutational status, the previous treatment regimen, or efficacy of the previous treatment. There were no severe postprocedural complications such as pneumothorax or serious haemorrhage.

Conclusions TBB is considered one of the safest and most useful procedures for rebiopsy of NSCLC that has relapsed after chemotherapy, regardless of patient background and treatment history.

  • Bronchoscopy
  • Lung Cancer
  • Non-Small Cell Lung Cancer

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  • Contributors HI and KA contributed to the study concept design and drafting of the manuscript. KY, NM, MN, TT, TK and TH contributed to data analysis and interpretation, study design, statistical analysis, and review of the manuscript. All authors had full access to the data of the study, take responsibility for the integrity and accuracy of data analysis, critically reviewed the manuscript, and approved the final version of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The present study was conducted in accordance with the provisions of the Declaration of Helsinki and was approved by the Institutional Review Board of Kurume University Hospital (IRB number 12029).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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