Melina E. Marmarelis , Dylan G. Scholes , Cindy M. McGrath , Salvatore F. Priore , Jacquelyn J. Roth , Michael Feldman , Jennifer J.D. Morrissette , Leslie Litzky , Charu Deshpande , Jeffrey C. Thompson , Abigail Doucette , Peter E. Gabriel , Lova Sun , Aditi P. Singh , Roger B. Cohen , Corey J. Langer , Erica L. Carpenter , Charu Aggarwal
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引用次数: 0
摘要
基于 DNA 的分子基因分型是初次诊断转移性非鳞状非小细胞肺癌患者治疗的重要组成部分。我们假设,由病理学家发起的条件反射检测途径的实施将缓解订购组织 DNA 分子基因分型的后勤障碍和挑战。我们在宾夕法尼亚大学开展了一项回顾性队列研究。符合条件的患者在 2015-2019 年间被组织学或细胞学诊断为转移性非鳞状非小细胞肺癌。患者被分为2个队列:启动条件反射检测途径前(2015-2016年)和启动条件反射检测途径后(2017-2019年)。采用双尾Z检验比较反射实施前后的比例(α=0.05)。在2015年1月1日至2019年12月31日期间,共纳入了529项基于DNA组织的分子检测,其中172项是在启动条件反射检测前进行的,357项是在启动条件反射途径后进行的。实施反射路径后,每位患者完成的基于DNA组织的检测比例从42%(172次检测/410名患者)上升至58%(357次检测/617名患者)(p<0.001)。实施反射途径后,用于分子检测的细胞学标本比例从 43/172(25%)增至 194/357(54%)(p<0.001)。与固定组织标本相比,液体细胞学标本DNA组织分子基因分型结果的中位周转时间更短(中位24天对27天,p=0.003)。在单个机构中,实施反射路径提高了成功进行基于DNA组织的分子检测的患者比例。我们的研究表明,利用反射检测途径可以消除基于组织的综合分子基因分型的障碍。
Brief Report: Impact of Reflex Testing on Tissue-Based Molecular Genotyping in Patients With Advanced Non-Squamous Non-Small Cell Lung Cancer
•
Timely molecular testing is integral to determining the best treatment for patients with non-small cell lung cancer. In small studies, reflex molecular testing on pathology samples has been shown to improve timeliness and rates of molecular testing. In our study, we show that implementation of reflex molecular genotyping on tissue-based tests at a large academic center improved the proportion of patients with successful DNA molecular testing. In addition, liquid cytology specimens proved to be a rich DNA source that may spare tissue for other testing or clinical trial eligibility.
期刊介绍:
Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.