Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
© 2024 Korean Society of Gastrointestinal Endoscopy
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest
Dr. Mizuno reports grants and fees from Yakult Honsha, Novartis, MSD, Ono Pharmaceutical, ASLAN Pharmaceuticals, Incyte, Seagen, Taiho Pharmaceutical and Dainippon Sumitomo Pharma.; none of the grants are connected with the submitted work. The other authors have no potential conflicts of interest.
Funding
None.
Acknowledgments
We thank the members of Aichi Cancer Center Hospital for their support of this study.
Author Contributions
Conceptualization: TaY, KH; Data curation: TaY; Investigation: TaY; Methodology: KH; Project administration: KH; Resources: TaY, SH, TK, NO, YK, NM, MY, SI, TsY; Supervision: KH; Visualization: TaY; Writing–original draft: TaY; Writing–review & editing: all authors.
Values are presented as median (range) or number only.
EUS-TA, endoscopic ultrasound-guided tissue acquisition; MSK-IMPACT, Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets.
a)Other samples: skin biopsy (2), bronchoscopic biopsy (1), endoscopic biopsy (1), computed tomography guided biopsy (1).
Values are presented as number (%).
ICC, intrahepatic cholangiocarcinoma; GBC, gallbladder cancer; ECC, extrahepatic cholangiocarcinoma; IDH1, isocitrate dehydrogenase-1; FGFR2, fibroblast growth factor receptor 2; NTRK, neurotrophic receptor tyrosine kinase; ERBB2, receptor tyrosine-protein kinase erbB 2; RET, rearranged during transfection; MSI-H, microsatellite instability-high; TMB-high, tumor mutational burden-high.
Samples | Patient (n=94) | Sample (n=105) | EUS-TA sample (n=51) | Surgical sample (n=32) | Percutaneous liver biopsy sample (n=17) | Other samples (n=5)a) |
---|---|---|---|---|---|---|
Median age (yr) | 65 (42–82) | |||||
Sex (female/male) | 46/48 | |||||
Diagnosis | ||||||
Intrahepatic cholangiocarcinoma | 37 | 43 | 21 | 8 | 12 | 2 |
Gallbladder cancer | 34 | 35 | 18 | 10 | 4 | 3 |
Gallbladder neuroendocrine carcinoma | 2 | 2 | 2 | 0 | 0 | 0 |
Extrahepatic cholangiocarcinoma | 17 | 18 | 6 | 11 | 1 | 0 |
Papilla neuroendocrine carcinoma | 2 | 3 | 1 | 2 | 0 | 0 |
Papilla adenocarcinoma | 1 | 3 | 3 | 0 | 0 | 0 |
Bile duct neuroendocrine tumor | 1 | 1 | 0 | 1 | 0 | 0 |
Genomic panel test | ||||||
Foundation One CDx | 41 | 41 | 15 | 25 | 1 | 0 |
OncoGuide NCC Oncopanel System | 36 | 36 | 21 | 4 | 10 | 1 |
MSK-IMPACT | 4 | 4 | 3 | 1 | 0 | 0 |
Sample | Adequacy (%, n/total n) |
---|---|
Total | 77 (81/105) |
EUS-TA | |
No. of punctures | 76 (39/51) |
Median (range) | 3 (1–6) |
Target size (mm, median [range]) | 33 [8-95] |
Targets | |
Liver | 84.4 (27/32) |
Lymph node | 55.6 (5/9) |
Gallbladder | 100.0 (4/4) |
Bile duct | 50.0 (2/4) |
Pancreatic metastasis | 50.0 (1/2) |
Needle gauge | |
19-G | 93.1 (27/29) |
22-G | 60.0 (12/20) |
25-G | 0 (0/2) |
Needle type | |
FNA | 37.5 (3/8) |
FNB | 83.7 (36/43) |
Surgical specimens | 93.8 (30/32) |
Percutaneous liver biopsy | 64.7 (11/17) |
Othersa) | 20.0 (1/5) |
Factor | Adequacy (%, n/total n) | Univariate p-value |
---|---|---|
Needle gauge | 0.013 | |
19-G | 93.1 (27/29) | |
22-G | 54.5 (12/22) | |
25-G | 0 (0/2) | |
Needle type | 0.013 | |
FNA | 37.5 (3/8) | |
FNB | 83.7 (36/43) | |
Needle | <0.001 | |
22-G+19-G FNB | 85.7 (36/42) | |
Others | 33.3 (3/9) | |
Target 1 | 0.015 | |
Primary lesion | 87.9 (29/33) | |
Metastasis | 55.6 (10/18) | |
Target 2 | 0.10 | |
Liver lesion | 84.4 (27/32) | |
Others | 63.2 (12/19) | |
Target size (mm) | <0.001 | |
≥30 | 100.0 (30/30) | |
<30 | 42.9 (9/21) | |
No. of punctures (time) | 0.016 | |
≥3 | 90.0 (27/30) | |
<3 | 57.1 (12/21) | |
Puncture route | 0.32 | |
Transgastric | 68.2 (15/22) | |
Transduodenal | 82.8 (24/29) |
Genomic panel test | 19-G FNB (n=29) | 22-G FNB (n=13) | Others (n=9) | p-value |
---|---|---|---|---|
Foundation One CDx | 13 (44.8) | 2 (15.4) | 0 (0) | 0.016 |
MSK-IMPACT | 2 (6.9) | 1 (7.7) | 0 (0) | 0.71 |
OncoGuide NCC | 12 (41.4) | 6 (46.2) | 3 (33.3) | 0.83 |
Inadequate | 2 (6.9) | 4 (30.8) | 6 (66.7) | <0.001 |
Therapeutic molecular markers | ICC (n=31) | GBC (n=28) | ECC (n=14) |
---|---|---|---|
IDH1 mutation | 3 (9.7) | 0 (0) | 0 (0) |
FGFR2 fusion | 4 (12.9) | 0 (0) | 0 (0) |
NTRK fusion | 0 (0) | 0 (0) | 0 (0) |
BRF V600E mutation | 0 (0) | 0 (0) | 0 (0) |
ERBB2 amplification | 0 (0) | 6 (21.4) | 0 (0) |
RET fusion | 0 (0) | 0 (0) | 0 (0) |
MSI-H | 0 (0) | 0 (0) | 0 (0) |
TMB-high | 0 (0) | 5 (17.9) | 0 (0) |
Values are presented as median (range) or number only. EUS-TA, endoscopic ultrasound-guided tissue acquisition; MSK-IMPACT, Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets. a)Other samples: skin biopsy (2), bronchoscopic biopsy (1), endoscopic biopsy (1), computed tomography guided biopsy (1).
EUS-TA, endoscopic ultrasound-guided tissue acquisition; FNA, fine needle aspiration; FNB, fine needle biopsy. a)Others: skin biopsy (2), bronchoscopic biopsy (1), endoscopic biopsy (1), computed tomography guided biopsy (1).
FNA, fine needle aspiration; FNB, fine needle biopsy.
Values are presented as number (%). EUS-TA, endoscopic ultrasound-guided tissue acquisition; FNB, fine needle biopsy; MSK-IMPACT, Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets.
Values are presented as number (%). ICC, intrahepatic cholangiocarcinoma; GBC, gallbladder cancer; ECC, extrahepatic cholangiocarcinoma; IDH1, isocitrate dehydrogenase-1; FGFR2, fibroblast growth factor receptor 2; NTRK, neurotrophic receptor tyrosine kinase; ERBB2, receptor tyrosine-protein kinase erbB 2; RET, rearranged during transfection; MSI-H, microsatellite instability-high; TMB-high, tumor mutational burden-high.