EGFR mutation status yield from bronchoalveolar lavage in patients with primary pulmonary adenocarcinoma compared to a venous blood sample and tissue biopsy

Nikolay Yanev; Evgeni Mekov; Dinko Valev; Georgi Yankov; Vladimir Milanov; Stoyan Bichev; Natalia Gabrovska; Dimitar Kostadinov

doi:10.7717/peerj.11448

EGFR mutation status yield from bronchoalveolar lavage in patients with primary pulmonary adenocarcinoma compared to a venous blood sample and tissue biopsy

PeerJ. 2021 May 14:9:e11448. doi: 10.7717/peerj.11448. eCollection 2021.

Authors

Nikolay Yanev¹, Evgeni Mekov¹, Dinko Valev², Georgi Yankov¹, Vladimir Milanov¹, Stoyan Bichev³, Natalia Gabrovska¹, Dimitar Kostadinov¹

Affiliations

¹ Department of Pulmonary Diseases, Medical University - Sofia, Sofia, Bulgaria.
² University Hospital "St. Ioan Krustitel", Sofia, Bulgaria.
³ National Genetics Laboratory, Medical University - Sofia, Sofia, Bulgaria.

Abstract

Background: In recent years, there has been a revolution in the genomic profiling and molecular typing of lung cancer. A key oncogene is the epidermal growth factor receptor (EGFR). The gold standard for determining EGFR mutation status is tissue biopsy, where a histological specimen is taken by a bronchoscopic or surgical method (transbronchial biopsy, forceps biopsy, etc.). However, in clinical practice the tissue sample is often insufficient for morphological and molecular analysis. Bronchoalveolar lavage is a validated diagnostic method for pathogenic infections in the lower respiratory tract, yet its diagnostic value for oncogenic mutation testing in lung cancer has not been extensively investigated. This study aims to compare the prevalence of EGFR mutation status in bronchoalveolar lavage and peripheral blood referring to the gold standard - tissue biopsy in patients with primary lung adenocarcinoma.

Methods: Twenty-six patients with adenocarcinoma were examined for EGFR mutation from tissue biopsy, peripheral blood sample and bronchoalveolar lavage.

Results: Thirteen patients had wild type EGFR and the other 13 had EGFR mutation. EGFR mutation from a peripheral blood sample was identified in 38.5% (5/13) of patients, whereas EGFR mutation obtained from bronchoalveolar lavage (BAL) was identified in 92.3% (12/13). This study demonstrates that a liquid biopsy sample for EGFR status from BAL has a higher sensitivity compared to a venous blood sample.

Keywords: Adenocarcinoma; Bronchoalveolar lavage; EGFR; Liquid biopsy; Lung cancer.

Grants and funding

This work was supported by the Medical University—Sofia Grant D-72/23.04.2019. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.