Real-world diagnostic accuracy and use of immunohistochemical markers in lung cancer diagnostics
(2021) In Biomolecules 11(11).- Abstract
Objectives: Accurate and reliable diagnostics are crucial as histopathological type influ-ences selection of treatment in lung cancer. The aim of this study was to evaluate real-world accuracy and use of immunohistochemical (IHC) staining in lung cancer diagnostics. Materials and Methods: The diagnosis and used IHC stains for small specimens with lung cancer on follow-up resection were retrospectively investigated for a 15-month period at two major sites in Sweden. Additionally, 10 pathologists individually suggested diagnostic IHC staining for 15 scanned bronchial and lung biopsies and cytological specimens. Results: In 16 (4.7%) of 338 lung cancer cases, a discordant diagnosis of potential clinical relevance was seen between a small... (More)
Objectives: Accurate and reliable diagnostics are crucial as histopathological type influ-ences selection of treatment in lung cancer. The aim of this study was to evaluate real-world accuracy and use of immunohistochemical (IHC) staining in lung cancer diagnostics. Materials and Methods: The diagnosis and used IHC stains for small specimens with lung cancer on follow-up resection were retrospectively investigated for a 15-month period at two major sites in Sweden. Additionally, 10 pathologists individually suggested diagnostic IHC staining for 15 scanned bronchial and lung biopsies and cytological specimens. Results: In 16 (4.7%) of 338 lung cancer cases, a discordant diagnosis of potential clinical relevance was seen between a small specimen and the fol-low-up resection. In half of the cases, there was a different small specimen from the same investi-gational work-up with a concordant diagnosis. Diagnostic inaccuracy was often related to a squa-mous marker not included in the IHC panel (also seen for the scanned cases), the case being a neu-roendocrine tumor, thyroid transcription factor-1 (TTF-1) expression in squamous cell carcinomas (with clone SPT24), or poor differentiation. IHC was used in about 95% of cases, with a higher number of stains in biopsies and in squamous cell carcinomas and especially neuroendocrine tumors. Pre-surgical transthoracic samples were more often diagnostic than bronchoscopic ones (72–85% vs. 9–53% for prevalent types). Conclusions: Although a high overall diagnostic accuracy of small specimens was seen, small changes in routine practice (such as consequent inclusion of p40 and TTF-1 clone 8G7G3/1 in the IHC panel for non-small cell cancer with unclear morphology) may lead to improvement, while reducing the number of IHC stains would be preferable from a time and cost perspective.
(Less)
- author
- Lindquist, Kajsa Ericson
LU
; Gudinaviciene, Inga
; Mylona, Nektaria
; Urdar, Rodrigo
; Lianou, Maria
LU
; Darai-Ramqvist, Eva
; Haglund, Felix
; Béndek, Mátyás
; Bardoczi, Erika
; Dobra, Katalin
LU
and Brunnström, Hans
LU
(Less) - organization
- publishing date
- 2021-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Biopsy, Bronchoscopy, Cytology, Sampling, Transthoracic, TTF-1
- in
- Biomolecules
- volume
- 11
- issue
- 11
- article number
- 1721
- publisher
- MDPI AG
- external identifiers
-
- pmid:34827719
- scopus:85119136574
- ISSN
- 2218-273X
- DOI
- 10.3390/biom11111721
- project
- Histopathological and molecular diagnostics of lung cancer
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
- id
- d31e09f5-a918-4d3b-a1a3-a98ee6a69693
- date added to LUP
- 2022-01-21 16:33:15
- date last changed
- 2024-06-16 00:16:29
@article{d31e09f5-a918-4d3b-a1a3-a98ee6a69693,
abstract = {{<p>Objectives: Accurate and reliable diagnostics are crucial as histopathological type influ-ences selection of treatment in lung cancer. The aim of this study was to evaluate real-world accuracy and use of immunohistochemical (IHC) staining in lung cancer diagnostics. Materials and Methods: The diagnosis and used IHC stains for small specimens with lung cancer on follow-up resection were retrospectively investigated for a 15-month period at two major sites in Sweden. Additionally, 10 pathologists individually suggested diagnostic IHC staining for 15 scanned bronchial and lung biopsies and cytological specimens. Results: In 16 (4.7%) of 338 lung cancer cases, a discordant diagnosis of potential clinical relevance was seen between a small specimen and the fol-low-up resection. In half of the cases, there was a different small specimen from the same investi-gational work-up with a concordant diagnosis. Diagnostic inaccuracy was often related to a squa-mous marker not included in the IHC panel (also seen for the scanned cases), the case being a neu-roendocrine tumor, thyroid transcription factor-1 (TTF-1) expression in squamous cell carcinomas (with clone SPT24), or poor differentiation. IHC was used in about 95% of cases, with a higher number of stains in biopsies and in squamous cell carcinomas and especially neuroendocrine tumors. Pre-surgical transthoracic samples were more often diagnostic than bronchoscopic ones (72–85% vs. 9–53% for prevalent types). Conclusions: Although a high overall diagnostic accuracy of small specimens was seen, small changes in routine practice (such as consequent inclusion of p40 and TTF-1 clone 8G7G3/1 in the IHC panel for non-small cell cancer with unclear morphology) may lead to improvement, while reducing the number of IHC stains would be preferable from a time and cost perspective.</p>}},
author = {{Lindquist, Kajsa Ericson and Gudinaviciene, Inga and Mylona, Nektaria and Urdar, Rodrigo and Lianou, Maria and Darai-Ramqvist, Eva and Haglund, Felix and Béndek, Mátyás and Bardoczi, Erika and Dobra, Katalin and Brunnström, Hans}},
issn = {{2218-273X}},
keywords = {{Biopsy; Bronchoscopy; Cytology; Sampling; Transthoracic; TTF-1}},
language = {{eng}},
number = {{11}},
publisher = {{MDPI AG}},
series = {{Biomolecules}},
title = {{Real-world diagnostic accuracy and use of immunohistochemical markers in lung cancer diagnostics}},
url = {{http://dx.doi.org/10.3390/biom11111721}},
doi = {{10.3390/biom11111721}},
volume = {{11}},
year = {{2021}},
}