A Bronchial Genomic Classifier for the Diagnostic Evaluation of Lung Cancer

A bronchial-airway gene-expression classifier that is used in combination with results on bronchoscopy helps to identify intermediate-risk patients who are unlikely to have lung cancer. Lesions that are suspicious for lung cancer are frequently identified on chest imaging. The decision to pursue sur...

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Bibliographic Details
Published inThe New England journal of medicine Vol. 373; no. 3; pp. 243 - 251
Main Authors Silvestri, Gerard A, Vachani, Anil, Whitney, Duncan, Elashoff, Michael, Porta Smith, Kate, Ferguson, J. Scott, Parsons, Ed, Mitra, Nandita, Brody, Jerome, Lenburg, Marc E, Spira, Avrum
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 16.07.2015
Subjects
Area Under Curve
Benign
Bronchoscopy
Bronchus
Epithelial cells
Gene Expression
Gene Expression Profiling
Humans
Invasiveness
Lung cancer
Lung Neoplasms - diagnosis
Lung Neoplasms - genetics
Medical diagnosis
Patients
Prospective Studies
Pulmonary lesions
Respiratory tract
ROC Curve
Sensitivity and Specificity
Smoking
United States > US
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Summary:A bronchial-airway gene-expression classifier that is used in combination with results on bronchoscopy helps to identify intermediate-risk patients who are unlikely to have lung cancer. Lesions that are suspicious for lung cancer are frequently identified on chest imaging. The decision to pursue surveillance imaging or an invasive evaluation requires an assessment of the likelihood of cancer, the ability to biopsy, the surgical risk, and the patient’s preferences. 1 When biopsy is required, the approach can include bronchoscopy, transthoracic needle biopsy, or surgical lung biopsy. The choice among these procedures is determined on the basis of considerations such as lesion size and location, the presence of adenopathy, the risk associated with the procedure, and local expertise. Bronchoscopy is relatively safe, with less than 1% of procedures complicated . . .
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Drs. Silvestri and Vachani contributed equally to this article.
A complete list of investigators in the AEGIS (Airway Epithelial Gene Expression in the Diagnosis of Lung Cancer) Study Team is provided in the Supplementary Appendix, available at NEJM.org.
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJMoa1504601