Department of Pathology, Scott & White Memorial Hospital and Texas A&M University Health Science Center, Temple, Texas 76504, USA.
Cancer Cytopathol. 2013 Jul;121(7):361-9. doi: 10.1002/cncy.21273. Epub 2013 Jan 30.
The detection of epidermal growth factor receptor (EGFR) mutations on small biopsy or fine-needle aspiration samples is required to guide therapy in nonsmall cell lung cancer (NSCLC). In this study, the authors compared results from EGFR mutation testing on both cytologic smears and surgical specimens and also compared the performance of platforms using 2 different technologies (pyrosequencing and real-time polymerase chain reaction) for both specimen types.
Specimens from 114 patients were divided into 2 subsets. The first subset had 60 paired cytology smears and surgical specimens, including 37 paired specimens from the same site and 23 paired specimens from different sites. The second subset consisted of nonpaired cytology smears and formalin-fixed, paraffin-embedded (FFPE) tissues (including 8 cell blocks), which were compared on the pyrosequencing and real-time polymerase chain reaction platforms. Laser-capture microscopy was used to enrich tumor in the FFPE specimens before DNA extraction.
All cytology smears that were used in the study were adequate for analysis on both platforms. Comparison between smears and concurrent FFPE tissues from the same anatomic site had a concordance rate of 97%. The concordance rate between the pyrosequencing platform and the real-time polymerase chain reaction platform was 84% and 85% for FFPE tissues and cytology smears, respectively.
The current results indicated that direct extraction and analysis of EGFR mutations from cytology smears can be performed successfully on both a pyrosequencing platform and a real-time polymerase chain reaction platform with results comparable to those achieved in matched surgical specimens. In fine-needle aspiration/endobronchial ultrasound samples with limited tissue, cytology smears can be important for molecular analysis. Cancer (Cancer Cytopathol) 2013;121:361-369. © 2012 American Cancer Society.
表皮生长因子受体（EGFR）突变的检测在小活检或细针抽吸样本中需要指导治疗非小细胞肺癌（NSCLC）。在这项研究中，作者比较了细胞学涂片和手术标本上的 EGFR 突变检测结果，并比较了两种不同技术（焦磷酸测序和实时聚合酶链反应）在两种标本类型上的性能。
114 例患者的标本分为两组。第一组有 60 对细胞学涂片和手术标本，包括 37 对来自同一部位的标本和 23 对来自不同部位的标本。第二组由非配对的细胞学涂片和福尔马林固定、石蜡包埋（FFPE）组织（包括 8 个细胞块）组成，在焦磷酸测序和实时聚合酶链反应平台上进行比较。在提取 DNA 之前，使用激光捕获显微镜对 FFPE 标本中的肿瘤进行富集。
所有用于研究的细胞学涂片都可以在两个平台上进行分析。来自同一解剖部位的涂片与同时期 FFPE 组织的比较具有 97%的一致性率。焦磷酸测序平台与实时聚合酶链反应平台之间的一致性率分别为 FFPE 组织和细胞学涂片的 84%和 85%。
目前的结果表明，直接从细胞学涂片提取和分析 EGFR 突变可以在焦磷酸测序平台和实时聚合酶链反应平台上成功进行，结果与匹配的手术标本相似。在组织有限的细针抽吸/支气管内超声样本中，细胞学涂片对于分子分析非常重要。癌症（癌症细胞病理学）2013；121:361-369。©2012 美国癌症协会。
