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Factors influencing concordance of pd-l1 expression between biopsies and cytological specimens in non-small cell lung cancer

Mansour, Mohammed S.I. LU orcid ; Hejny, Kim ; Johansson, Felicia ; Mufti, Joudy ; Vidis, Ante ; Mager, Ulrich ; Dejmek, Annika LU ; Seidal, Tomas and Brunnström, Hans LU orcid (2021) In Diagnostics 11(10).
Abstract

PD-L1 expression assessed by immunohistochemical staining is used for the selection of immunotherapy in non-small cell lung cancer (NSCLC). Appropriate validation of PD-L1 expression in cytology specimens is important as cytology is often the only diagnostic material in NSCLC. In a previous study comprising two different cohorts of paired biopsies and cytological specimens, we found a fairly good cyto-histological correlation of PD-L1 expression in one, whereas only a moderate correlation was found in the other cohort. Therefore, that cohort with additional new cases was now further investigated for the impact of preanalytical factors on PD-L1 concordance in paired biopsies and cytological specimens. A total of 100 formalin-fixed... (More)

PD-L1 expression assessed by immunohistochemical staining is used for the selection of immunotherapy in non-small cell lung cancer (NSCLC). Appropriate validation of PD-L1 expression in cytology specimens is important as cytology is often the only diagnostic material in NSCLC. In a previous study comprising two different cohorts of paired biopsies and cytological specimens, we found a fairly good cyto-histological correlation of PD-L1 expression in one, whereas only a moderate correlation was found in the other cohort. Therefore, that cohort with additional new cases was now further investigated for the impact of preanalytical factors on PD-L1 concordance in paired biopsies and cytological specimens. A total of 100 formalin-fixed paraffin-embedded cell blocks from 19 pleural effusions (PE), 17 bronchial brushes (BB), and 64 bronchoalveolar lavage (BAL) and concurrent matched biopsies from 80 bronchial biopsies and 20 transthoracic core biopsies from NSCLC patients were stained using the PD-L1 28-8 assay. Using the cutoffs ≥1%, ≥5%, ≥10%, and ≥50% positive tumour cells, the overall agreement between histology and cytology was 77–85% (κ 0.51–0.70) depending on the applied cutoff value. The concordance was better for BALs (κ 0.53–0.81) and BBs (κ 0.55–0.85) than for PEs (κ −0.16–0.48), while no difference was seen for different types of biopsies or histological tumour type. A high number of tumour cells (>500) in biopsies was associated with better concordance at the ≥50% cutoff. In conclusion, the study results suggest that PEs may be less suitable for evaluation of PD-L1 due to limited cyto-histological concordance, while a high amount of tumour cells in biopsies may be favourable when regarding cyto-histological PD-L1 concordance.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
28-8, Biopsy, Bronchial brush, Bronchoalveolar lavage, Cell block, Im-munohistochemistry, Pleural effusion
in
Diagnostics
volume
11
issue
10
article number
1927
publisher
MDPI AG
external identifiers
  • pmid:34679625
  • scopus:85117849237
ISSN
2075-4418
DOI
10.3390/diagnostics11101927
project
Improvement of diagnostic and prognostic cytopathology of lung cancer and malignant mesothelioma.
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
id
1ed81688-0139-4047-a393-b613520cae78
date added to LUP
2021-11-23 12:07:46
date last changed
2024-06-15 21:14:42
@article{1ed81688-0139-4047-a393-b613520cae78,
  abstract     = {{<p>PD-L1 expression assessed by immunohistochemical staining is used for the selection of immunotherapy in non-small cell lung cancer (NSCLC). Appropriate validation of PD-L1 expression in cytology specimens is important as cytology is often the only diagnostic material in NSCLC. In a previous study comprising two different cohorts of paired biopsies and cytological specimens, we found a fairly good cyto-histological correlation of PD-L1 expression in one, whereas only a moderate correlation was found in the other cohort. Therefore, that cohort with additional new cases was now further investigated for the impact of preanalytical factors on PD-L1 concordance in paired biopsies and cytological specimens. A total of 100 formalin-fixed paraffin-embedded cell blocks from 19 pleural effusions (PE), 17 bronchial brushes (BB), and 64 bronchoalveolar lavage (BAL) and concurrent matched biopsies from 80 bronchial biopsies and 20 transthoracic core biopsies from NSCLC patients were stained using the PD-L1 28-8 assay. Using the cutoffs ≥1%, ≥5%, ≥10%, and ≥50% positive tumour cells, the overall agreement between histology and cytology was 77–85% (κ 0.51–0.70) depending on the applied cutoff value. The concordance was better for BALs (κ 0.53–0.81) and BBs (κ 0.55–0.85) than for PEs (κ −0.16–0.48), while no difference was seen for different types of biopsies or histological tumour type. A high number of tumour cells (&gt;500) in biopsies was associated with better concordance at the ≥50% cutoff. In conclusion, the study results suggest that PEs may be less suitable for evaluation of PD-L1 due to limited cyto-histological concordance, while a high amount of tumour cells in biopsies may be favourable when regarding cyto-histological PD-L1 concordance.</p>}},
  author       = {{Mansour, Mohammed S.I. and Hejny, Kim and Johansson, Felicia and Mufti, Joudy and Vidis, Ante and Mager, Ulrich and Dejmek, Annika and Seidal, Tomas and Brunnström, Hans}},
  issn         = {{2075-4418}},
  keywords     = {{28-8; Biopsy; Bronchial brush; Bronchoalveolar lavage; Cell block; Im-munohistochemistry; Pleural effusion}},
  language     = {{eng}},
  number       = {{10}},
  publisher    = {{MDPI AG}},
  series       = {{Diagnostics}},
  title        = {{Factors influencing concordance of pd-l1 expression between biopsies and cytological specimens in non-small cell lung cancer}},
  url          = {{http://dx.doi.org/10.3390/diagnostics11101927}},
  doi          = {{10.3390/diagnostics11101927}},
  volume       = {{11}},
  year         = {{2021}},
}