Next-generation sequencing (NGS) has become increasingly important for the comprehensive search of various driver oncogenes in non-small cell lung cancer (NSCLC). As NGS requires specimens of high quality and quantity, those obtained by conventional bronchoscopy are sometimes insufficient. Cryobiopsy has the potential to address this limitation, but its utility, especially for peripheral pulmonary lesions (PPLs), has not been well investigated.

Consecutive patients diagnosed with NSCLC by bronchoscopy for PPLs at our hospital between 2019 and 2022 were reviewed. Of them, cases whose specimens were submitted to amplicon-based NGS for 46 genes were extracted, as of the January 2023 data cutoff. If that NGS was actually performed and any driver oncogene was detected, or if all were negative, it was considered successful. Clinical factors that contributed to the success of the NGS were analyzed, including use of cryobiopsy.

Of the 248 eligible patients, 84 (33.9%) underwent cryobiopsy. The median age was 69 (26?90) years, 138 (55.6%) were male, and 196 (79.0%) had adenocarcinoma. Overall, 209 cases (84.3%) were successfully analyzed by the NGS, and those with cryobiopsy had a significantly higher success rate than those without (91.7% vs. 80.5%, p=0.022). In multivariable analysis, use of cryobiopsy (p=0.022; adjusted odds ratio [OR], 2.82; 95% confidence interval [CI], 1.16?6.88) was a significant factor associated with NGS success, along with solid morphology (p=0.022; adjusted OR, 3.54; 95% CI, 1.20?10.43).

In conclusion, cryobiopsy would be useful for obtaining specimens from PPLs for NGS purposes.