Optimizing core needle biopsy specimen collection techniques to enhance molecular testing adequacy in non-small cell lung cancer

作者：Zeyun Lin, Jiaxin Tang, Anzi Tan, Shiqi Tang, Yuqin Li, Yingying Gu, Chunping Liu, Mengshi Li, Zhucheng Chen, Yuying Chen, Yuxin Zhang, Ping He, Qiuhua Deng, Wenhua Liang, Jianxing He, Juhong Jiang · 发表于：Journal of Thoracic Disease · 年份：2025 · DOI：10.21037/jtd-2025-521 · 被引用次数：2 · 研究领域：Lung Cancer Treatments and Mutations、Molecular Biology Techniques and Applications、Cancer Genomics and Diagnostics

Background: Core needle biopsy (CNB) is commonly used for histological diagnosis and molecular testing in patients with non-small cell lung cancer (NSCLC). However, the adequacy of CNB specimens is often compromised by low tumor cell content or insufficient nucleic acid quantity, which can negatively impact the success of downstream analyses. Moreover, variations in specimen collection techniques may further contribute to inconsistency in sample quality. This retrospective study aimed to assess and optimize CNB specimen collection methods to improve sample adequacy for molecular testing in NSCLC. Methods: A total of 546 CNB specimens from NSCLC patients were collected using three different techniques: (I) steam sterilization indicator cards; (II) polypropylene microporous membranes (PPMM) pieces for tissue adherence; and (III) direct rinsing of biopsy needles with sterilized buffer. Cell pellets were harvested from the residual fixative medium after CNB processing. Tumor cellularity was evaluated in formalin-fixed paraffin-embedded (FFPE) tissues and cell pellet samples from each method. Results: Adequacy rates for molecular testing were 86.4% in FFPE samples and 92.3% in cell pellet samples. Incorporating cell pellet analysis increased overall molecular testing adequacy to 95.2%. Among the evaluated techniques, the steam sterilization indicator cards cohort yielded the lowest adequacy rates for both FFPE and cell pellet samples. The PPMM technique achieved the highest adequa...