Subtyping of Undifferentiated Non-small Cell Carcinomas in Bronchial Biopsy Specimens
The emergence of treatments for non-small cell lung carcinoma (NSCLC) with differential efficacy and toxicity between subtypes has highlighted the importance of specific pathologic NSCLC subtyping. Most NSCLCs are inoperable, and pathologic diagnosis is made only on small tissue samples that are pro...
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Veröffentlicht in: | Journal of thoracic oncology 2010-04, Vol.5 (4), p.442-447 |
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description | The emergence of treatments for non-small cell lung carcinoma (NSCLC) with differential efficacy and toxicity between subtypes has highlighted the importance of specific pathologic NSCLC subtyping. Most NSCLCs are inoperable, and pathologic diagnosis is made only on small tissue samples that are prone to diagnostic inaccuracy. In a substantial proportion of cases, standard morphology cannot specifically subtype the tumor, necessitating a diagnosis of NSCLC-not otherwise specified (NOS). Histochemical staining for mucin and immunohistochemical (IHC) identification of NSCLC subtype-associated markers could help predict the final subtype of resected NSCLCs diagnosed as NSCLC-NOS on preoperative bronchial biopsy samples.
Paraffin sections of 44 bronchial biopsy samples diagnosed as NSCLC-NOS were stained for mucin (Alcian blue/periodic acid Schiff) and thyroid transcription factor 1 by IHC–(markers of adenocarcinoma), and for S100A7, cytokeratin 5/6, high molecular weight cytokeratins, and p63 proteins–markers of squamous cell carcinoma. A predictive staining panel was derived from statistical analysis after comparing staining profiles with the final postsurgical NSCLC subtype. This panel was prospectively applied to 82 small biopsy samples containing NSCLC.
True NSCLC subtype of undifferentiated NSCLC samples was best predicted using Alcian blue/periodic acid Schiff plus p63 and thyroid transcription factor 1 IHC, allowing specific subtyping in 73% of NSCLC-NOS cases with 86% accuracy. When applied prospectively, this staining panel showed 100% concordance with specific NSCLC morphologic subtyping in small biopsies.
This approach can facilitate treatment selection by accurately predicting the subtype in undifferentiated NSCLC biopsies, reducing to 7% the proportion of cases without a definite or probable histologic subtype. |
doi_str_mv | 10.1097/JTO.0b013e3181d40fac |
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Paraffin sections of 44 bronchial biopsy samples diagnosed as NSCLC-NOS were stained for mucin (Alcian blue/periodic acid Schiff) and thyroid transcription factor 1 by IHC–(markers of adenocarcinoma), and for S100A7, cytokeratin 5/6, high molecular weight cytokeratins, and p63 proteins–markers of squamous cell carcinoma. A predictive staining panel was derived from statistical analysis after comparing staining profiles with the final postsurgical NSCLC subtype. This panel was prospectively applied to 82 small biopsy samples containing NSCLC.
True NSCLC subtype of undifferentiated NSCLC samples was best predicted using Alcian blue/periodic acid Schiff plus p63 and thyroid transcription factor 1 IHC, allowing specific subtyping in 73% of NSCLC-NOS cases with 86% accuracy. When applied prospectively, this staining panel showed 100% concordance with specific NSCLC morphologic subtyping in small biopsies.
This approach can facilitate treatment selection by accurately predicting the subtype in undifferentiated NSCLC biopsies, reducing to 7% the proportion of cases without a definite or probable histologic subtype.</description><identifier>ISSN: 1556-0864</identifier><identifier>EISSN: 1556-1380</identifier><identifier>DOI: 10.1097/JTO.0b013e3181d40fac</identifier><identifier>PMID: 20195168</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenocarcinoma - classification ; Adenocarcinoma - metabolism ; Adenocarcinoma - pathology ; Biomarkers, Tumor - metabolism ; Biopsy, Fine-Needle ; Bronchi - metabolism ; Bronchi - pathology ; Bronchial biopsy diagnosis ; Carcinoma, Large Cell - classification ; Carcinoma, Large Cell - metabolism ; Carcinoma, Large Cell - pathology ; Carcinoma, Non-Small-Cell Lung - classification ; Carcinoma, Non-Small-Cell Lung - metabolism ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Squamous Cell - classification ; Carcinoma, Squamous Cell - metabolism ; Carcinoma, Squamous Cell - pathology ; Cell Differentiation ; Humans ; Immunoenzyme Techniques ; Immunohistochemistry ; Keratin-5 - metabolism ; Keratin-6 - metabolism ; Lung Neoplasms - classification ; Lung Neoplasms - metabolism ; Lung Neoplasms - pathology ; Mucins - metabolism ; Neoplasm Staging ; Non-small cell lung carcinoma ; NSCLC subtype ; NSCLC-NOS ; Nuclear Proteins - metabolism ; p63 ; Predictive value ; Prognosis ; Prospective Studies ; S100 Calcium Binding Protein A7 ; S100 Proteins - metabolism ; Sensitivity and Specificity ; Survival Rate ; Thyroid Nuclear Factor 1 ; Trans-Activators - metabolism ; Transcription Factors - metabolism ; TTF1 ; Tumor Suppressor Proteins - metabolism ; Undifferentiated carcinoma</subject><ispartof>Journal of thoracic oncology, 2010-04, Vol.5 (4), p.442-447</ispartof><rights>2010 International Association for the Study of Lung Cancer</rights><rights>2010International Association for the Study of Lung Cancer</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522c-964c271d1a4055d4fd68cfc4a13255d68a9bbfdf36abd5a13c54980b742b91943</citedby><cites>FETCH-LOGICAL-c522c-964c271d1a4055d4fd68cfc4a13255d68a9bbfdf36abd5a13c54980b742b91943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27931,27932</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20195168$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Loo, Peh Sun</creatorcontrib><creatorcontrib>Thomas, Stuart C.</creatorcontrib><creatorcontrib>Nicolson, Marianne C.</creatorcontrib><creatorcontrib>Fyfe, Margaret N.</creatorcontrib><creatorcontrib>Kerr, Keith M.</creatorcontrib><title>Subtyping of Undifferentiated Non-small Cell Carcinomas in Bronchial Biopsy Specimens</title><title>Journal of thoracic oncology</title><addtitle>J Thorac Oncol</addtitle><description>The emergence of treatments for non-small cell lung carcinoma (NSCLC) with differential efficacy and toxicity between subtypes has highlighted the importance of specific pathologic NSCLC subtyping. Most NSCLCs are inoperable, and pathologic diagnosis is made only on small tissue samples that are prone to diagnostic inaccuracy. In a substantial proportion of cases, standard morphology cannot specifically subtype the tumor, necessitating a diagnosis of NSCLC-not otherwise specified (NOS). Histochemical staining for mucin and immunohistochemical (IHC) identification of NSCLC subtype-associated markers could help predict the final subtype of resected NSCLCs diagnosed as NSCLC-NOS on preoperative bronchial biopsy samples.
Paraffin sections of 44 bronchial biopsy samples diagnosed as NSCLC-NOS were stained for mucin (Alcian blue/periodic acid Schiff) and thyroid transcription factor 1 by IHC–(markers of adenocarcinoma), and for S100A7, cytokeratin 5/6, high molecular weight cytokeratins, and p63 proteins–markers of squamous cell carcinoma. A predictive staining panel was derived from statistical analysis after comparing staining profiles with the final postsurgical NSCLC subtype. This panel was prospectively applied to 82 small biopsy samples containing NSCLC.
True NSCLC subtype of undifferentiated NSCLC samples was best predicted using Alcian blue/periodic acid Schiff plus p63 and thyroid transcription factor 1 IHC, allowing specific subtyping in 73% of NSCLC-NOS cases with 86% accuracy. When applied prospectively, this staining panel showed 100% concordance with specific NSCLC morphologic subtyping in small biopsies.
This approach can facilitate treatment selection by accurately predicting the subtype in undifferentiated NSCLC biopsies, reducing to 7% the proportion of cases without a definite or probable histologic subtype.</description><subject>Adenocarcinoma - classification</subject><subject>Adenocarcinoma - metabolism</subject><subject>Adenocarcinoma - pathology</subject><subject>Biomarkers, Tumor - metabolism</subject><subject>Biopsy, Fine-Needle</subject><subject>Bronchi - metabolism</subject><subject>Bronchi - pathology</subject><subject>Bronchial biopsy diagnosis</subject><subject>Carcinoma, Large Cell - classification</subject><subject>Carcinoma, Large Cell - metabolism</subject><subject>Carcinoma, Large Cell - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - classification</subject><subject>Carcinoma, Non-Small-Cell Lung - metabolism</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Squamous Cell - classification</subject><subject>Carcinoma, Squamous Cell - metabolism</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Cell Differentiation</subject><subject>Humans</subject><subject>Immunoenzyme Techniques</subject><subject>Immunohistochemistry</subject><subject>Keratin-5 - metabolism</subject><subject>Keratin-6 - metabolism</subject><subject>Lung Neoplasms - classification</subject><subject>Lung Neoplasms - metabolism</subject><subject>Lung Neoplasms - pathology</subject><subject>Mucins - metabolism</subject><subject>Neoplasm Staging</subject><subject>Non-small cell lung carcinoma</subject><subject>NSCLC subtype</subject><subject>NSCLC-NOS</subject><subject>Nuclear Proteins - metabolism</subject><subject>p63</subject><subject>Predictive value</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>S100 Calcium Binding Protein A7</subject><subject>S100 Proteins - metabolism</subject><subject>Sensitivity and Specificity</subject><subject>Survival Rate</subject><subject>Thyroid Nuclear Factor 1</subject><subject>Trans-Activators - metabolism</subject><subject>Transcription Factors - metabolism</subject><subject>TTF1</subject><subject>Tumor Suppressor Proteins - metabolism</subject><subject>Undifferentiated carcinoma</subject><issn>1556-0864</issn><issn>1556-1380</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtOwzAQRS0EoqXwBwjlB1LsxE6dDRKteArRRdt15NhjakjsyE6p-vekSmHBAjbz0j1XmovQJcFjgvPJ9fNyPsYlJimkhBNFsRbyCA0JY1lMUo6PDzPmGR2gsxDeMaYMU36KBgkmOSMZH6LVYlO2u8bYt8jpaGWV0Ro82NaIFlT06mwcalFV0Qz2RXhprKtFiIyNpt5ZuTaiiqbGNWEXLRqQpgYbztGJFlWAi0MfodX93XL2GL_MH55mty-xZEki4zyjMpkQRQTFjCmqVcalllSQNOn2jIu8LLXSaSZKxbqrZDTnuJzQpMxJTtMRor2v9C4ED7povKmF3xUEF_uUii6l4ndKHXbVY82mrEH9QN-xdALeC7auasGHj2qzBV-sQVTt-j_vmx6F7u9P01FBGrASlPEg20I587fBFxrmjIU</recordid><startdate>201004</startdate><enddate>201004</enddate><creator>Loo, Peh Sun</creator><creator>Thomas, Stuart C.</creator><creator>Nicolson, Marianne C.</creator><creator>Fyfe, Margaret N.</creator><creator>Kerr, Keith M.</creator><general>Elsevier Inc</general><general>International Association for the Study of Lung Cancer</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201004</creationdate><title>Subtyping of Undifferentiated Non-small Cell Carcinomas in Bronchial Biopsy Specimens</title><author>Loo, Peh Sun ; Thomas, Stuart C. ; Nicolson, Marianne C. ; Fyfe, Margaret N. ; Kerr, Keith M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c522c-964c271d1a4055d4fd68cfc4a13255d68a9bbfdf36abd5a13c54980b742b91943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adenocarcinoma - classification</topic><topic>Adenocarcinoma - metabolism</topic><topic>Adenocarcinoma - pathology</topic><topic>Biomarkers, Tumor - metabolism</topic><topic>Biopsy, Fine-Needle</topic><topic>Bronchi - metabolism</topic><topic>Bronchi - pathology</topic><topic>Bronchial biopsy diagnosis</topic><topic>Carcinoma, Large Cell - classification</topic><topic>Carcinoma, Large Cell - metabolism</topic><topic>Carcinoma, Large Cell - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - classification</topic><topic>Carcinoma, Non-Small-Cell Lung - metabolism</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Squamous Cell - classification</topic><topic>Carcinoma, Squamous Cell - metabolism</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Cell Differentiation</topic><topic>Humans</topic><topic>Immunoenzyme Techniques</topic><topic>Immunohistochemistry</topic><topic>Keratin-5 - metabolism</topic><topic>Keratin-6 - metabolism</topic><topic>Lung Neoplasms - classification</topic><topic>Lung Neoplasms - metabolism</topic><topic>Lung Neoplasms - pathology</topic><topic>Mucins - metabolism</topic><topic>Neoplasm Staging</topic><topic>Non-small cell lung carcinoma</topic><topic>NSCLC subtype</topic><topic>NSCLC-NOS</topic><topic>Nuclear Proteins - metabolism</topic><topic>p63</topic><topic>Predictive value</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>S100 Calcium Binding Protein A7</topic><topic>S100 Proteins - metabolism</topic><topic>Sensitivity and Specificity</topic><topic>Survival Rate</topic><topic>Thyroid Nuclear Factor 1</topic><topic>Trans-Activators - metabolism</topic><topic>Transcription Factors - metabolism</topic><topic>TTF1</topic><topic>Tumor Suppressor Proteins - metabolism</topic><topic>Undifferentiated carcinoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Loo, Peh Sun</creatorcontrib><creatorcontrib>Thomas, Stuart C.</creatorcontrib><creatorcontrib>Nicolson, Marianne C.</creatorcontrib><creatorcontrib>Fyfe, Margaret N.</creatorcontrib><creatorcontrib>Kerr, Keith M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Journal of thoracic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Loo, Peh Sun</au><au>Thomas, Stuart C.</au><au>Nicolson, Marianne C.</au><au>Fyfe, Margaret N.</au><au>Kerr, Keith M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Subtyping of Undifferentiated Non-small Cell Carcinomas in Bronchial Biopsy Specimens</atitle><jtitle>Journal of thoracic oncology</jtitle><addtitle>J Thorac Oncol</addtitle><date>2010-04</date><risdate>2010</risdate><volume>5</volume><issue>4</issue><spage>442</spage><epage>447</epage><pages>442-447</pages><issn>1556-0864</issn><eissn>1556-1380</eissn><abstract>The emergence of treatments for non-small cell lung carcinoma (NSCLC) with differential efficacy and toxicity between subtypes has highlighted the importance of specific pathologic NSCLC subtyping. Most NSCLCs are inoperable, and pathologic diagnosis is made only on small tissue samples that are prone to diagnostic inaccuracy. In a substantial proportion of cases, standard morphology cannot specifically subtype the tumor, necessitating a diagnosis of NSCLC-not otherwise specified (NOS). Histochemical staining for mucin and immunohistochemical (IHC) identification of NSCLC subtype-associated markers could help predict the final subtype of resected NSCLCs diagnosed as NSCLC-NOS on preoperative bronchial biopsy samples.
Paraffin sections of 44 bronchial biopsy samples diagnosed as NSCLC-NOS were stained for mucin (Alcian blue/periodic acid Schiff) and thyroid transcription factor 1 by IHC–(markers of adenocarcinoma), and for S100A7, cytokeratin 5/6, high molecular weight cytokeratins, and p63 proteins–markers of squamous cell carcinoma. A predictive staining panel was derived from statistical analysis after comparing staining profiles with the final postsurgical NSCLC subtype. This panel was prospectively applied to 82 small biopsy samples containing NSCLC.
True NSCLC subtype of undifferentiated NSCLC samples was best predicted using Alcian blue/periodic acid Schiff plus p63 and thyroid transcription factor 1 IHC, allowing specific subtyping in 73% of NSCLC-NOS cases with 86% accuracy. When applied prospectively, this staining panel showed 100% concordance with specific NSCLC morphologic subtyping in small biopsies.
This approach can facilitate treatment selection by accurately predicting the subtype in undifferentiated NSCLC biopsies, reducing to 7% the proportion of cases without a definite or probable histologic subtype.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>20195168</pmid><doi>10.1097/JTO.0b013e3181d40fac</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adenocarcinoma - classification Adenocarcinoma - metabolism Adenocarcinoma - pathology Biomarkers, Tumor - metabolism Biopsy, Fine-Needle Bronchi - metabolism Bronchi - pathology Bronchial biopsy diagnosis Carcinoma, Large Cell - classification Carcinoma, Large Cell - metabolism Carcinoma, Large Cell - pathology Carcinoma, Non-Small-Cell Lung - classification Carcinoma, Non-Small-Cell Lung - metabolism Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Squamous Cell - classification Carcinoma, Squamous Cell - metabolism Carcinoma, Squamous Cell - pathology Cell Differentiation Humans Immunoenzyme Techniques Immunohistochemistry Keratin-5 - metabolism Keratin-6 - metabolism Lung Neoplasms - classification Lung Neoplasms - metabolism Lung Neoplasms - pathology Mucins - metabolism Neoplasm Staging Non-small cell lung carcinoma NSCLC subtype NSCLC-NOS Nuclear Proteins - metabolism p63 Predictive value Prognosis Prospective Studies S100 Calcium Binding Protein A7 S100 Proteins - metabolism Sensitivity and Specificity Survival Rate Thyroid Nuclear Factor 1 Trans-Activators - metabolism Transcription Factors - metabolism TTF1 Tumor Suppressor Proteins - metabolism Undifferentiated carcinoma |
title | Subtyping of Undifferentiated Non-small Cell Carcinomas in Bronchial Biopsy Specimens |
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