Cytomorphology is often insufficient to categorize non‐small‐cell lung carcinoma on F<scp>NA</scp> specimens

Witt, Benjamin L.; Cohen, Michael B.; Chadwick, Barbara; Stephenson, Philip D.; Abasolo, Peter A.; Schmidt, Robert L.

doi:10.1002/dc.23387

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…This may be the reason why the positive rate of RT-PCR is higher than the IHC method. Tumor tissue biopsy samples are the main sample types for clinical testing, including bronchoscopy, ultrasound bronchoscopy or percutaneous lung biopsy [37,38]. However, tissue biopsy has many limitations.…”

Section: Discussionmentioning

confidence: 99%

Comparison of EML4-ALK fusion gene positive rate in different detection methods and samples of non-small cell lung cancer

Lü

Xiao

et al. 2020

J. Cancer

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Objective: To evaluate differences of EML4-ALK positive rates in tissues samples between immunohistochemistry, reverse transcriptase polymerase chain reaction and the next-generation sequencing method. Besides, to compare the differences of EML4-ALK positive rates in blood samples and tissue samples by next-generation sequencing. The results provide a basis for the selection of a suitable EML4-ALK fusion gene detection method. Methods: Immunohistochemistry analysis of EML4-ALK in tumors was performed on samples from 2631 patients with non-small cell lung cancer. The mutation of EML4-ALK in the tissue samples of 399 patients with non-small cell lung cancer was detected by reverse transcription polymerase chain reaction. Next-generation sequencing was used to detect the mutation of EML4-ALK in 1505 non-small cell lung cancer patients, including 1208 tissue samples and 297 blood samples. Results: The positive incidence of EML4-ALK by immunohistochemistry was 7.11% (187/2631). Histologically, 9.51% (170/1787) of the samples were lung adenocarcinomas, and 2.01% (17/844) were squamous cell carcinomas. The positive rate of EML4-ALK was 8.52% (34/399) in 399 patients with non-small cell lung cancer, as detected by reverse transcription polymerase chain reaction; the mutation rate of adenocarcinoma was 11.62% (33/284), and the mutation rate of squamous cell carcinoma was 0.86% (1/115). In 1208 patients with non-small cell lung cancer with tissue samples, the positive rate of EML4-ALK was 4.88% (59/1208), as determined by next-generation sequencing, the mutation rate of adenocarcinoma was 5.84% (58/994), and the mutation rate of squamous cell carcinoma was 0.47% (1/214). The positive rate of EML4-ALK detected by reverse transcription polymerase chain reaction was higher than that detected by immunohistochemistry. Compared with the next-generation sequencing results, the positive rates of EML4-ALK detected by immunohistochemistry and reverse transcription polymerase chain reaction were higher, and the differences were significant (p<0.05). In blood samples from 297 patients with non-small cell lung cancer, the positive rate of EML4-ALK detected by next-generation sequencing was 3.70% (11/297), the mutation rate of adenocarcinoma was 3.82% (10/262), and the mutation rate of squamous cell carcinoma was 2.86% (1/35). The EML4-ALK positive rate of the tissue samples was thus higher than that of the blood biopsy samples. Conclusion: Among the three methods for detecting EML4-ALK, reverse transcription polymerase chain reaction has the highest positive rate, followed by immunohistochemistry, and next-generation sequencing has the lowest positive rate. The positive detection rate of EML4-ALK in tissue samples by next-generation sequencing was higher than that in blood samples.

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Section: Discussionmentioning

confidence: 99%

Comparison of EML4-ALK fusion gene positive rate in different detection methods and samples of non-small cell lung cancer

Lü

Xiao

et al. 2020

J. Cancer

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“…Subsolid nodules were associated with higher odds of false-negative biopsy (OR 3.95), while granulomatous inflammation and documentation of needle tip within target were associated with lower odds of false negative biopsy (OR 0.04 and 0.37, respectively). Further, Witt and colleagues studied 50 cases of NSCLC diagnosed by FNA with concurrent core biopsy or resection as a reference standard (57). They found that interobserver agreement in classifying cases as squamous cell or adenocarcinoma was poor at 0.22 when an indeterminate category was included and 0.1 when it was not, with overall accuracy for differentiating these two pathologies at 65% and 66% respectively.…”

Section: Minimally Invasive Methods To Biopsy Ipnsmentioning

confidence: 99%

Narrative review: indeterminate pulmonary nodules

Wadowski¹,

Bueno²

2022

Curr Chall Thorac Surg

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The detection of indeterminate pulmonary nodules (IPNs) has become common through more frequent use of sensitive axial imaging and implementation of lung cancer screening protocols.Differentiating benign and malignant lesions can be challenging, particularly when nodules are small, but presents a critical opportunity to detect early cancers and improve patient outcomes. There are many noninvasive and invasive approaches to characterizing IPNs, representing an ongoing clinical need and an area of active research. This article will first provide a brief overview of the epidemiology of IPNs and discuss the implications of lung cancer screening. It will then review the use of clinical scores, radiographic features, and noninvasive molecular approaches in risk stratifying IPNs with an emphasis on sub-centimeter lesions. In particular, the evidence underlying peripherally accessible DNA, RNA, and protein-based "liquid biopsies" will be explored. This article will then describe techniques to optimize the diagnostic yield of minimally invasive tissue sampling methods including percutaneous transthoracic needle biopsies and endobronchial ultrasound-guided fine needle aspiration, as well as approaches to optimize lesion localization for surgical diagnosis. The review will conclude with a discussion of several molecular tests that provide insight into possible ways to overcome histologically indeterminate or nondiagnostic biopsy results in the future.

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“…A small biopsy involves taking a small piece of diseased tissue for pathologic examination for the purposes of obtaining a preoperative diagnosis and optimizing the corresponding treatment. The means for this type of sampling include bronchial fiberscopic techniques, ultrasonic bronchoscopy or percutaneous lung biopsy [ 15 , 16 ]. The advantages of small biopsies are that they are minimally invasive, simple operations with fewer complications and greater patient acceptance that can generally be performed as outpatient procedures.…”

Section: Introductionmentioning

confidence: 99%

Comparison of small biopsy specimens and surgical specimens for the detection of EGFR mutations and EML4-ALK in non-small-cell lung cancer

et al. 2016

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Epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) fusion genes represent novel oncogenes that are associated with non–small-cell lung cancers (NSCLC). The feasibility of detecting EGFR mutations and ALK fusion genes in small biopsy specimens or surgical specimens was determined. Of the 721 NSCLC patients, a total of 305 cases were positive for EGFR mutations (42.3%). The rate of EGFR mutations in women was significantly higher than that in men. Histologically, the EGFR mutation rate in adenocarcinomas was significantly higher than that in squamous cell carcinomas. No difference in the EGFR mutation rate was observed between surgical specimens (42.1%) and small biopsy specimens (42.4%), which indicated that the EGFR mutation ratios in surgical specimens and small biopsy specimens were not different. In 385 NSCLC patients, 26 cases were positive for EML4-ALK (6.8%). However, 11.7% of the surgical specimens were EML4-ALK-positive, whereas the positive proportion in the small biopsy specimens was only 4.7%, which indicated that EML4-ALK-positive rate in the surgical specimens was significantly higher than that in the small biopsy specimens. Detection of EGFR gene mutations was feasible in small biopsy specimens, and screening for EML4-ALK expression in small biopsy specimens can be used to guide clinical treatments.

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Cytomorphology is often insufficient to categorize non‐small‐cell lung carcinoma on FNA specimens

Abstract: Overall, the low interobserver agreement in our study indicates that accurate subclassification between the NSCLCs often cannot be made by cytomorphology alone.

Cited by 5 publications

References 21 publications

Comparison of EML4-ALK fusion gene positive rate in different detection methods and samples of non-small cell lung cancer

Comparison of EML4-ALK fusion gene positive rate in different detection methods and samples of non-small cell lung cancer

Narrative review: indeterminate pulmonary nodules

Comparison of small biopsy specimens and surgical specimens for the detection of EGFR mutations and EML4-ALK in non-small-cell lung cancer

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