Mohammed S I Mansour1,2, Kajsa Ericson Lindquist3, Tomas Seidal1, Ulrich Mager4, Rikard Mohlin3, Lena Tran5, Kim Hejny1, Benjamin Holmgren1, Despoina Violidaki3, Katalin Dobra6, Annika Dejmek7, Maria Planck5,8, Hans Brunnström2,3. 1. Department of Pathology and Cytology, Halland Hospital Halmstad, Halmstad, Sweden. 2. Division of Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden. 3. Department of Genetics and Pathology, Laboratory Medicine Region Skåne, Lund, Sweden. 4. Division of Respiratory and Internal Medicine, Department of Clinical Medicine, Halland Hospital Halmstad, Halmstad, Sweden. 5. Division of Oncology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund, Sweden. 6. Division of Clinical Pathology/Cytology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden. 7. Department of Translational Medicine in Malmö, Lund University, Malmö, Sweden. 8. Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund, Sweden.
Abstract
INTRODUCTION: Programmed death-ligand 1 (PD-L1) expression is used for treatment prediction in non-small cell lung cancer (NSCLC). While cytology may be the only available material in the routine clinical setting, testing in clinical trials has mainly been based on biopsies. METHODS: We included 2 retrospective cohorts of paired, concurrently sampled, cytological specimens and biopsies. Also, the literature on PD-L1 in paired cytological/histological samples was reviewed. Focus was on the cutoff levels ≥1 and ≥50% positive tumor cells. RESULTS: Using a 3-tier scale, PD-L1 was concordant in 40/47 (85%) and 66/97 (68%) of the paired NSCLC cases in the 2 cohorts, with kappa 0.77 and 0.49, respectively. In the former cohort, all discordant cases had lower score in cytology. In both cohorts, concordance was lower in samples from different sites (e.g., biopsy from primary tumor and cytology from pleural effusion). Based on 25 published studies including about 1,700 paired cytology/histology cases, the median (range) concordance was 81-85% (62-100%) at cutoff 1% for a positive PD-L1 staining and 89% (67-100%) at cutoff 50%. CONCLUSIONS: The overall concordance of PD-L1 between cytology and biopsies is rather good but with significant variation between laboratories, which calls for local quality assurance.
INTRODUCTION: Programmed death-ligand 1 (PD-L1) expression is used for treatment prediction in non-small cell lung cancer (NSCLC). While cytology may be the only available material in the routine clinical setting, testing in clinical trials has mainly been based on biopsies. METHODS: We included 2 retrospective cohorts of paired, concurrently sampled, cytological specimens and biopsies. Also, the literature on PD-L1 in paired cytological/histological samples was reviewed. Focus was on the cutoff levels ≥1 and ≥50% positive tumor cells. RESULTS: Using a 3-tier scale, PD-L1 was concordant in 40/47 (85%) and 66/97 (68%) of the paired NSCLC cases in the 2 cohorts, with kappa 0.77 and 0.49, respectively. In the former cohort, all discordant cases had lower score in cytology. In both cohorts, concordance was lower in samples from different sites (e.g., biopsy from primary tumor and cytology from pleural effusion). Based on 25 published studies including about 1,700 paired cytology/histology cases, the median (range) concordance was 81-85% (62-100%) at cutoff 1% for a positive PD-L1 staining and 89% (67-100%) at cutoff 50%. CONCLUSIONS: The overall concordance of PD-L1 between cytology and biopsies is rather good but with significant variation between laboratories, which calls for local quality assurance.
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Authors: Mohammed S I Mansour; Karina Malmros; Ulrich Mager; Kajsa Ericson Lindquist; Kim Hejny; Benjamin Holmgren; Tomas Seidal; Annika Dejmek; Katalin Dobra; Maria Planck; Hans Brunnström Journal: Int J Mol Sci Date: 2022-04-19 Impact factor: 6.208