Common Markers (Cytokeratins 5/6&7, p63, TTF1, Vimentin) on Small Biopsies of Non-Small Cell Lung Cancer Effectively Parallel Profiling and Eventual Diagnoses of Surgical Specimens.
Giuseppe Pelosi, Mauro Papotti, Giulio Rossi, Angelica Sonzogni. National Cancer Institute, Milan, Italy; San Luigi Hospital and University of Turin, Orbassano, Italy; Azienda Ospedaliera-Universitaria Policlinico, Modena, Italy; European Institute of Oncology, Milan, Italy
Background: More detailed typing of non-small cell lung cancer (NSCLC) upon small biopsy specimens is increasingly required, albeit demanding with morphology alone. Little, however, is known about the likelihood of immunohistochemistry (IHC)-assessed small biopsies to effectively parallel profiling and hence eventual diagnoses of surgical specimens.
Design: Sixty-three preoperative biopsies and corresponding surgical specimens from 30 consecutive squamous cell carcinomas (SCC), 22 adenocarcinomas (AD), two adenosquamous carcinomas (ADSCC), eight pleomorphic carcinomas (PLC) and one yolk sac tumor were jointly evaluated semiquantitatively for cytokeratin 5/6 and 7, p63, TTF1 and vimentin immunoreactivity. Surgical specimens were the gold standard for morphology and IHC.
Results: Unsupervised clustering of surgical specimens and biopsies showed a nonrandom and overlapping distribution of the relevant markers, which closely correlated with each other and the diverse tumor categories, as confirmed by mosaic plot analysis. There were no differences in AUC-ROC curves for each marker between any two samples, with the exception of p63 that paralleled more effectively squamous cell carcinoma on biopsy than surgical specimen. 59/63 (94%) lesions were correctly classified by IHC on biopsy compared to 53/63 (84%) by revised morphology, with predictive positive value of diagnostic accuracy of 97% for SCC, 88% for AD, and 100% for PLC and ADSCC. Yolk sac tumor and three PLC, however, failed any diagnostic recognition.
Conclusions: Diverse cell differentiation lineages of NSCLC may be consistently detected by IHC in small biopsies, making the eventual typing of tumors effective in most cases.
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 282, Tuesday Afternoon