The current status of lung cancer multi-gene testing for non-small cell lung cancer diagnosed by EBUS-TBNA

<bold>Objective:</bold> This study aims to elucidate the current status of multi-testing in samples obtained through EBUS-TBNA at our hospital. <bold>Methods:</bold> We retrospectively examined the rate of multi-testing feasibility in EBUS-TBNA-diagnosed non-small cell lung cancer cases (n=60) at our hospital from June 2019 to December 2023. <bold>Results:</bold> The patient demographics included a median age of 71 years, 72% male, 83% smokers, and histological types Ad/Sq/NSCLC/Large were 37/13/9/1. Interstitial pneumonia was present in 13% of cases, with a median lymph node size of 19.1mm, median puncture attempts of 3, and a median examination time of 34 minutes. Multi-testing evaluation was performed in 30 cases (50%) within the hospital, Among these, the rates judged as feasible, with a tumor content of ≥20% or considered multi-testing possible, were 86.6% and 76.6%, respectively. The concordance rate between in-house and outsourced assessments in multi-testing was 94.7%, and biomarker positivity was 26.3%. Comparing 2019-2021 to 2022-2023, the proportion of cases undergoing multi-testing evaluation increased from 16.6% to 100%, and the proportion judged as feasible increased from 66.6% to 79.2%. The main reasons for not conducting multi-testing evaluation were single-test submission, interstitial pneumonia, and squamous cell carcinoma. <bold>Conclusion:</bold> The multi-testing evaluation and feasibility rate for non-small cell lung cancer at our hospital have increased over time, with a high concordance rate between in-house and outsourced assessments.