Info
🌱 來自: NSCLC
Diagnostic and staging evaluation-of-NSCLC
- Imaging:
- CT chest captures adrenals, PET scan to evaluate for distant dz, MR brain for pts treated w/ curative intent or sx, preoperative PFTs
- Tissue:
- Depending on site: EBUS-guided bronchoscopic or image-guided bx, thoracentesis (effusion), or video-assisted thoracoscopic surgery (VATS). Need sufficient tissue in all suspected lung CAs for dx: Histologic typing, IHC (incl. PD-L1 expression), & comprehensive molecular testing (esp stage IV), tissue-based NGS panel preferred. ctDNA ↑ Sn by stage, can be FN, FP clonal hematopoiesis of indeterminate potential (CHIP). Proceeding to surgery w/o bx ok for stage I
- Mediastinal evaluation:
- Considered for nodes >1 cm on CT or PET+ via EBUS-guided bronchoscopy or mediastinoscopy
- Molecular testing:
- Actionable alterations in EGFR, ALK, ROS1, MET, RET, BRAF, HER2, NTRK1/2/3