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Updated: Jan 9, 2026
Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
Supernatant from endobronchial ultrasound-guided transbronchial needle aspiration samples for molecular profiling in
Luís Vaz Rodrigues1,2, Joana Oliveira3, Tiago Maricoto4
1Pulmonology Department, Francisco Gentil Portuguese Institute of Oncology of Coimbra, Coimbra, Portugal luis.vaz.rodrigues@gmail.com.
Background:
Molecular profiling has become essential in the management of nonsmall cell lung cancer (NSCLC). While endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a cornerstone in diagnosis, tissue scarcity may hinder comprehensive testing. Recent studies suggest that supernatant from EBUS-TBNA could serve as an alternative source for molecular analysis.
Methods:
A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO identifier CRD42024600046). Studies from 2000 to 2024 evaluating the feasibility, molecular concordance and turnaround time of EBUS-TBNA supernatant for molecular profiling in NSCLC were included. Outcomes included DNA yield, detection of actionable mutations and agreement with tissue-based results.
Results:
Seven studies (n=506 patients) were included. Feasibility of molecular analysis using supernatant was high (87-100%). DNA yields varied across studies. In pooled analysis, storage temperature and preservation solution had no significant effect, while individual studies reported lower yields with high-speed centrifugation. Concordance with tissue samples ranged from 83% to 100%, with Cohen's κ 0.947 (95% CI 0.905-0.989), indicating an almost perfect agreement. Supernatant samples demonstrated faster turnaround times (reduction of 1-7.5 days).
Conclusions:
EBUS-TBNA supernatant is a feasible and accurate source for molecular testing in NSCLC, with high concordance and shorter turnaround times. Standardisation of protocols is required before broader implementation in clinical practice.
