М.S. Burdyukov - Ph.D. (Med.) Russian Cancer Research Center of N.N. Blokhin (Mosсow). E-mail: burdyukov@rambler.ru I.N. Yurichev - An endoscopist, Russian Cancer Research Center of N.N. Blokhin (Mosсow) A.M. Nechipay - Dr. Sc. (Med.), Professor, Head of Endoscopy Chair, Medical Academy of Postgraduate Education (Moscow) D.I. Yudin - Ph.D. (Med.), Russian Cancer Research Center of N.N. Blokhin (Mosсow) O.V. Chistyakova - Ph.D. (Med.), Russian Cancer Research Center of N.N. Blokhin (Mosсow) K.K. Lactionov - Dr.Sc. (Med.), Head of Department of Clinical Biotechnology, Russian Cancer Research Center of N.N. Blokhin (Mosсow) B.I. Dolgushin - Dr.Sc. (Med.), Professor, Head of X-ray Department, Russian Cancer Research Center of N.N. Blokhin (Mosсow) D.T. Marinov - Researcher, Russian Cancer Research Center of N.N. Blokhin (Mosсow) G.V. Ungiadzhe - Dr.Sc. (Med.), Head of Endoscopy Department, Russian Cancer Research Center of N.N. Blokhin (Mosсow)

Lung cancer is a disease which takes first place in death-rate among other oncological diseases, despite the success of х-ray- and chemotherapy combined with surgical treatment. Modern policy of medicamental antitumoral treatment is based on realization of individual approach to the treatment of each single patient. Detecting of target genetical mutations in tumoral tissue and selection of target chemodrugs affecting exactly the link of pathologic processes chain, which provide for vital functions and expansive growth of tumor, allows to achieve desirable antitumoral effect and quite often considerably improves the result and individual prognosis of treatment. Fine-needle aspiration under control of transesophageal endosonography (EUS-FNA) of lung tumor and metastatic nodes of mediastinum is a technique which allows to take samles of tumoral tissue for morphological verification of diagnosis and genetical analysis for the purpose of detecting dotted target mutations. This research was launched taking into consideration the few in number data regarding the opportunities of the technique, its role and place in the diagnostic procedure of patients suffering from lung cancer. The aim o f the data is to demonstrate the role and the place of EUS-FNA in the procedure of examination of patients suffering from lung cancer in planning and selection of individual chemotherapy. The main are to assess the opportunities of EUS-FNA in taking appropriate material for morphological verification of diagnosis and for detecting target mutations for the purpose of the selection of optimal chemotherapeutical medicine. 34 (77%) of patients with non-small-celled lung cancer were determined to have adenocarcionona, 10 (23%) ? epidermoid cancer. Bioptic material of 27 (79%) from 34 patients with the diagnosis of adenocarcionoma was directed to genetical analysis for the purpose of detecting mutations in target genes. In 16 (59,3%) from them no mutations in the genes under research were detected; in 8 - mutations in the gene EGFR were detected; in 3 of them - in the gene ALK. EUS-FNA in the diagnostic procedure allows to take appropriate material for the characteristic of tumoral process and for following genetical analysis for the purpose of selection of personalized chemotherapy.

 

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