INTRODUCTION: The dichotomization of non-small cell carcinoma (NSCLC) subtype into squamous (SQCC) and adenocarcinoma (ADC) has become important in recent years and is increasingly required with regard to management. The aim of this study was to determine the utility of a panel of commercially available antibodies in refining the diagnosis on small biopsies and also to determine whether cytologic material is suitable for somatic EGFR genotyping in a prospectively analyzed series of patients undergoing investigation for suspected lung cancer. METHODS: Thirty-two consecutive cases of NSCLC were first tested using a panel comprising cytokeratin 5/6, P63, thyroid transcription factor-1, 34betaE12, and a D-PAS stain for mucin, to determine their value in refining diagnosis of NSCLC. After this test phase, two further pathologists independently reviewed the cases using a refined panel that excluded 34betaE12 because of its low specificity for SQCC, and refinement of diagnosis and concordance were assessed. Ten cases of ADC, including eight derived from cytologic samples, were sent for EGFR mutation analysis. RESULTS: There was refinement of diagnosis in 65% of cases of NSCLC to either SQCC or ADC in the test phase. This included 10 of 13 cases where cell pellets had been prepared from transbronchial needle aspirates. Validation by two further pathologists with varying expertise in lung pathology confirmed increased refinement and concordance of diagnosis. All samples were adequate for analysis, and they all showed a wild-type EGFR genotype. CONCLUSION: A panel comprising cytokeratin 5/6, P63, thyroid transcription factor-1, and a D-PAS stain for mucin increases diagnostic accuracy and agreement between pathologists when faced with refining a diagnosis of NSCLC to SQCC or ADC. These small samples, even cell pellets derived from transbronchial needle aspirates, seem to be adequate for EGFR mutation analysis.
INTRODUCTION: The dichotomization of non-small cell carcinoma (NSCLC) subtype into squamous (SQCC) and adenocarcinoma (ADC) has become important in recent years and is increasingly required with regard to management. The aim of this study was to determine the utility of a panel of commercially available antibodies in refining the diagnosis on small biopsies and also to determine whether cytologic material is suitable for somatic EGFR genotyping in a prospectively analyzed series of patients undergoing investigation for suspected lung cancer. METHODS: Thirty-two consecutive cases of NSCLC were first tested using a panel comprising cytokeratin 5/6, P63, thyroid transcription factor-1, 34betaE12, and a D-PAS stain for mucin, to determine their value in refining diagnosis of NSCLC. After this test phase, two further pathologists independently reviewed the cases using a refined panel that excluded 34betaE12 because of its low specificity for SQCC, and refinement of diagnosis and concordance were assessed. Ten cases of ADC, including eight derived from cytologic samples, were sent for EGFR mutation analysis. RESULTS: There was refinement of diagnosis in 65% of cases of NSCLC to either SQCC or ADC in the test phase. This included 10 of 13 cases where cell pellets had been prepared from transbronchial needle aspirates. Validation by two further pathologists with varying expertise in lung pathology confirmed increased refinement and concordance of diagnosis. All samples were adequate for analysis, and they all showed a wild-type EGFR genotype. CONCLUSION: A panel comprising cytokeratin 5/6, P63, thyroid transcription factor-1, and a D-PAS stain for mucin increases diagnostic accuracy and agreement between pathologists when faced with refining a diagnosis of NSCLC to SQCC or ADC. These small samples, even cell pellets derived from transbronchial needle aspirates, seem to be adequate for EGFR mutation analysis.
Authors: William D Travis; Elisabeth Brambilla; Masayuki Noguchi; Andrew G Nicholson; Kim Geisinger; Yasushi Yatabe; Yuichi Ishikawa; Ignacio Wistuba; Douglas B Flieder; Wilbur Franklin; Adi Gazdar; Philip S Hasleton; Douglas W Henderson; Keith M Kerr; Iver Petersen; Victor Roggli; Erik Thunnissen; Ming Tsao Journal: Arch Pathol Lab Med Date: 2012-09-12 Impact factor: 5.534
Authors: Lida P Hariri; Matthew B Applegate; Mari Mino-Kenudson; Eugene J Mark; Benjamin D Medoff; Andrew D Luster; Brett E Bouma; Guillermo J Tearney; Melissa J Suter Journal: Chest Date: 2013-01 Impact factor: 9.410
Authors: Lester J Layfield; Sinchita Roy-Chowdhuri; Zubair Baloch; Hormoz Ehya; Kim Geisinger; Susan J Hsiao; Oscar Lin; Neal I Lindeman; Michael Roh; Fernando Schmitt; Nikoletta Sidiropoulos; Paul A VanderLaan Journal: Diagn Cytopathol Date: 2016-08-26 Impact factor: 1.582
Authors: Erik Thunnissen; Evan Boers; Daniëlle A M Heideman; Katrien Grünberg; Dirk J Kuik; Arnold Noorduin; Matthijs van Oosterhout; Divera Pronk; Cees Seldenrijk; Hannie Sietsma; Egbert F Smit; Robertjan van Suylen; Jan von der Thusen; Bart Vrugt; Anne Wiersma; Birgit I Witte; Michael den Bakker Journal: Virchows Arch Date: 2012-10-12 Impact factor: 4.064
Authors: Anna Szumera-Ciećkiewicz; Włodzimierz T Olszewski; Andrzej Tysarowski; Dariusz M Kowalski; Maciej Głogowski; Maciej Krzakowski; Janusz A Siedlecki; Michał Wągrodzki; Monika Prochorec-Sobieszek Journal: Int J Clin Exp Pathol Date: 2013-11-15