P220 A service evaluation of the endobronchial ultrasound service (EBUS), including molecular diagnoses and patient satisfaction at university hospital service (UHS)

Background EBUS-Transbronchial Needle Aspiration (TBNA) is a minimally invasive procedure which collects biopsies in patients with mediastinal and/or hilar lymphadenopathy, often in lung cancer or sarcoidosis. Cancerous biopsies can undergo molecular testing to identify mutations, which may be targeted by immunotherapy. The role of EBUS-TBNA in molecular outcomes has not been studied previously in the UK. This study also explores patient demographics and satisfaction to evaluate EBUS-TBNA comprehensively.Aim To evaluate the EBUS-TBNA service at UHS, focusing on patient demographics, satisfaction, diagnostic outcomes, procedural statistics, and identifying targetable mutations for immunotherapy.Method 306 patients were studied retrospectively, and 39 were prospective, using a questionnaire. Data on their characteristics, reports, diagnoses, and molecular tests were recorded and analysed using SPSS.Results 47.12% were diagnosed with primary lung cancer, 23.38% with sarcoidosis, 9.71% with metastatic cancer and 1.95% with other diagnoses, such as tuberculosis. Primary lung cancer was categorised as adenocarcinoma (52.31%), squamous cell carcinoma (SCC) (25.38%) and small cell carcinoma (SCLC) (16.92%).Of the primary cancer cases, 60.31% underwent molecular testing. 29.41% of adenocarcinoma tested positive for a targetable mutation: 85% were KRAS G12C, and 15% were the EGFRE19del. Overall, 15.27% of EBUS-TBNA procedures for primary lung cancer revealed a clinically actionable variant.Of the 39 patients surveyed, there was a significant difference between pain experienced (median = 2/10, IQR = 4) and expected pain (median = 5/10, IQR = 6) using a Wilcoxon-signed ranked test (z = -2.91, p=0.004). The average experience with staff during the EBUS was 9.87/10 (SD = 0.47), and 55.85% waited <1 week for the procedure.Abstract P220 Table 1Number and ages of different EBUS-TBNA diagnosesConclusions EBUS-TBNA’s role in diagnosing various conditions, especially primary lung cancer, is clear.Clinically, EBUS-TBNA provides genetic diagnoses, which can enable immunotherapy. Patient satisfaction is high, with patients expressing relief after the procedure and finding the staff exceptional.