Molecular Analysis of EBUS-TBNA Samples for Nodal Staging in Non-Small Cell Lung Cancer

Since the discovery of EGFR mutations, treatment strategies have undergone major advances over the past two decades. Accordingly, molecular testing for oncogenic driver mutations is recommended at the time of diagnosis of advanced NSCLC. In addition, molecular analysis of lymph node samples has emerged as a promising tool for improving the accuracy of nodal staging in NSCLC. This approach may enhance the precision of staging in early-stage disease planned for curative surgical resection, thereby optimizing adjuvant treatment decisions and supporting complete resection at the time of surgery. In this review, we examine the importance and current status of molecular testing for oncogenic driver mutations in samples obtained via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) or EBUS-guided cryobiopsy, and its role in improving the accuracy of nodal staging in NSCLC.