Real-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics
Objectives: Accurate and reliable diagnostics are crucial as histopathological type influences 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 diagnos...
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MDPI AG
2021
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oai:doaj.org-article:28c57976469e4a1787e0dc9d74c128b42021-11-25T16:54:22ZReal-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics10.3390/biom111117212218-273Xhttps://doaj.org/article/28c57976469e4a1787e0dc9d74c128b42021-11-01T00:00:00Zhttps://www.mdpi.com/2218-273X/11/11/1721https://doaj.org/toc/2218-273XObjectives: Accurate and reliable diagnostics are crucial as histopathological type influences 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 follow-up resection. In half of the cases, there was a different small specimen from the same investigational work-up with a concordant diagnosis. Diagnostic inaccuracy was often related to a squamous marker not included in the IHC panel (also seen for the scanned cases), the case being a neuroendocrine 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.Kajsa Ericson LindquistInga GudinavicieneNektaria MylonaRodrigo UrdarMaria LianouEva Darai-RamqvistFelix HaglundMátyás BéndekErika BardocziKatalin DobraHans BrunnströmMDPI AGarticlebiopsybronchoscopycytologysamplingtransthoracicTTF-1MicrobiologyQR1-502ENBiomolecules, Vol 11, Iss 1721, p 1721 (2021) |
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| topic |
biopsy bronchoscopy cytology sampling transthoracic TTF-1 Microbiology QR1-502 |
| spellingShingle |
biopsy bronchoscopy cytology sampling transthoracic TTF-1 Microbiology QR1-502 Kajsa Ericson Lindquist Inga Gudinaviciene Nektaria Mylona Rodrigo Urdar Maria Lianou Eva Darai-Ramqvist Felix Haglund Mátyás Béndek Erika Bardoczi Katalin Dobra Hans Brunnström Real-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics |
| description |
Objectives: Accurate and reliable diagnostics are crucial as histopathological type influences 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 follow-up resection. In half of the cases, there was a different small specimen from the same investigational work-up with a concordant diagnosis. Diagnostic inaccuracy was often related to a squamous marker not included in the IHC panel (also seen for the scanned cases), the case being a neuroendocrine 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. |
| format |
article |
| author |
Kajsa Ericson Lindquist Inga Gudinaviciene Nektaria Mylona Rodrigo Urdar Maria Lianou Eva Darai-Ramqvist Felix Haglund Mátyás Béndek Erika Bardoczi Katalin Dobra Hans Brunnström |
| author_facet |
Kajsa Ericson Lindquist Inga Gudinaviciene Nektaria Mylona Rodrigo Urdar Maria Lianou Eva Darai-Ramqvist Felix Haglund Mátyás Béndek Erika Bardoczi Katalin Dobra Hans Brunnström |
| author_sort |
Kajsa Ericson Lindquist |
| title |
Real-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics |
| title_short |
Real-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics |
| title_full |
Real-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics |
| title_fullStr |
Real-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics |
| title_full_unstemmed |
Real-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics |
| title_sort |
real-world diagnostic accuracy and use of immunohistochemical markers in lung cancer diagnostics |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/28c57976469e4a1787e0dc9d74c128b4 |
| work_keys_str_mv |
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