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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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Autores principales: Ericson Lindquist, Kajsa, Gudinaviciene, Inga, Mylona, Nektaria, Urdar, Rodrigo, Lianou, Maria, Darai-Ramqvist, Eva, Haglund, Felix, Béndek, Mátyás, Bardoczi, Erika, Dobra, Katalin, Brunnström, Hans
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615395/
https://www.ncbi.nlm.nih.gov/pubmed/34827719
http://dx.doi.org/10.3390/biom11111721
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author Ericson Lindquist, Kajsa
Gudinaviciene, Inga
Mylona, Nektaria
Urdar, Rodrigo
Lianou, Maria
Darai-Ramqvist, Eva
Haglund, Felix
Béndek, Mátyás
Bardoczi, Erika
Dobra, Katalin
Brunnström, Hans
author_facet Ericson Lindquist, Kajsa
Gudinaviciene, Inga
Mylona, Nektaria
Urdar, Rodrigo
Lianou, Maria
Darai-Ramqvist, Eva
Haglund, Felix
Béndek, Mátyás
Bardoczi, Erika
Dobra, Katalin
Brunnström, Hans
author_sort Ericson Lindquist, Kajsa
collection PubMed
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.
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spelling pubmed-86153952021-11-26 Real-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics Ericson Lindquist, Kajsa Gudinaviciene, Inga Mylona, Nektaria Urdar, Rodrigo Lianou, Maria Darai-Ramqvist, Eva Haglund, Felix Béndek, Mátyás Bardoczi, Erika Dobra, Katalin Brunnström, Hans Biomolecules Article 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. MDPI 2021-11-18 /pmc/articles/PMC8615395/ /pubmed/34827719 http://dx.doi.org/10.3390/biom11111721 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ericson Lindquist, Kajsa
Gudinaviciene, Inga
Mylona, Nektaria
Urdar, Rodrigo
Lianou, Maria
Darai-Ramqvist, Eva
Haglund, Felix
Béndek, Mátyás
Bardoczi, Erika
Dobra, Katalin
Brunnström, Hans
Real-World Diagnostic Accuracy and Use of Immunohistochemical Markers in Lung Cancer Diagnostics
title 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_short 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
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615395/
https://www.ncbi.nlm.nih.gov/pubmed/34827719
http://dx.doi.org/10.3390/biom11111721
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