Clin Endosc.  2024 May;57(3):384-392. 10.5946/ce.2023.139.

Clinical utility of endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling of patients with biliary tract cancer, especially with intrahepatic cholangiocarcinoma

• Yanaidani T
• Hara K
• Okuno N
• Haba S
• Kuwahara T
• Kuraishi Y
• Mizuno N
• Ishikawa S
• Yamada M
• Yasuda T

• KMID: 2555900
• DOI: http://doi.org/10.5946/ce.2023.139

Abstract

Background/Aims
Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is a standard diagnostic method for biliary tract cancer (BTC), and samples obtained in this manner may be used for comprehensive genomic profiling (CGP). This study evaluated the utility of EUS-TA for CGP in a clinical setting and determined the factors associated with the adequacy of CGP in patients with BTC.
Methods
CGP was attempted for 105 samples from 94 patients with BTC at the Aichi Cancer Center, Japan, from October 2019 to April 2022.
Results
Overall, 77.1% (81/105) of the samples were adequate for CGP. For 22-G or 19-G fine-needle biopsy (FNB), the sample adequacy was 85.7% (36/42), which was similar to that of surgical specimens (94%, p=0.45). Univariate analysis revealed that 22-G or larger FNB needle usage (86%, p=0.003), the target primary lesions (88%, p=0.015), a target size ≥30 mm (100%, p=0.0013), and number of punctures (90%, p=0.016) were significantly positively associated with CGP sample adequacy.
Conclusions
EUS-TA is useful for CGP tissue sampling in patients with BTC. In particular, the use of 22-G or larger FNB needles may allow for specimen adequacy comparable to that of surgical specimens.

Keyword

Biliary tract cancer; Endoscopic ultrasound-guided fine needle aspiration; Fine needle biopsy; Genetic profiles; Precision medicine

Figure

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  Fig. 1. Flow diagram of the study. CGP, comprehensive genomic profiling.

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  Fig. 2. Genomic results of tissue-based comprehensive genomic profiling. ICC, intrahepatic cholangiocarcinoma; ECC, extrahepatic cholangiocarcinoma; GBC, gallbladder cancer; GN, gallbladder neuroendocrine carcinoma; PN, papilla neuroendocrine carcinoma; PA, papilla adenocarcinoma; BN, bile duct neuroendocrine tumor; IDH, isocitrate dehydrogenase; FGFR, fibroblast growth factor receptor; PIK3CA, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha; ERBB, receptor tyrosine-protein kinase erbB; BRCA, breast cancer susceptibility gene; MDM, murine double minute; CDKN, cyclin dependent kinase inhibitor; CDK, cyclin dependent kinase; NTKR, neurotrophic receptor tyrosine kinase; ALK, anaplastic lymphoma kinase; MSH, mutS homolog; KRAS, Kirsten rat sarcoma virus; ARID, AT-rich interactive domain-containing protein; MSI-H, microsatellite instability-high; TMB-H, tumor mutational burden-high.

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