Other diagnostic studies for adenocarcinoma of the lung include molecular test and endoscopic procedures.

Molecular test

• Molecular tissue tests look for certain changes in the genes of non–small cell lung cancer cells. These genetic mutations may change how much or the type of protein the cancer cells produce. These changes may affect the type of treatment given because some chemotherapy drugs may be more effective against cancer cells with these changes. Molecular tissue tests may also help predict prognosis.^[1]

• Molecular tissue tests for non-small cell lung cancer look for the genes responsible for:

• Epidermal growth factor receptor (EGFR)
• Anaplastic lymphoma fusion (ALK)

• Specific mutations in these genes are associated with a better response to some drugs.

Endoscopic procedures^[1]

• Bronchoscopy:

• A bronchoscopy may be done to look for a tumor inside the bronchi.
• During a bronchoscopy, the doctor may remove a sample of tissue or fluid to be examined under a microscope to diagnose non–small cell lung cancer.

• Mediastinoscopy or mediastinotomy:

• A mediastinoscopy may be done to look at the mediastinum
• The space in the chest between the lungs, sternum and spine that contains the heart, great blood vessels, thymus, trachea (windpipe), esophagus and lymph nodes and get samples of tissues in the area.
• A mediastinotomy is similar to mediastinoscopy. Instead of inserting an endoscope through a cut in the neck, the doctor makes a slightly larger incision between the ribs. This allows the doctor to examine lymph nodes that cannot be reached by a mediastinoscopy.

• Thoracoscopy (pleuroscopy):

• A thoracoscopy may be done to look at and sample tissue from the chest wall, mediastinum, outer lining of the lungs (pleura) and lymph nodes in the chest.
• Thoracoscopy is not often done to diagnose lung cancer. It may be used if other tests, such as bronchoscopy, cannot get enough tissue to make a diagnosis.

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