Patnaik Santosh, Mallick Reema, Kannisto Eric, Sharma Rohit, Bshara Wiam, Yendamuri Sai, Dhillon Samjot Singh
*Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263; †University of Minnesota, Minneapolis, MN 55455; and ‡Lehigh Valley Surgical Oncology, Bethlehem, PA 18017.
J Thorac Oncol. 2015 Mar;10(3):446-53. doi: 10.1097/JTO.0000000000000423.
Identification of adenocarcinoma (AC) and squamous cell carcinoma (SCC) histology of non-small-cell lung cancer (NSCLC) in biopsies is clinically important but can be inaccurate by routine histopathologic examination. We quantify this inaccuracy at a cancer center, and evaluate the utility of a microRNA-based method to histotype AC/SCC in biopsies.
RNA was extracted from tissue sections with greater than 90% tumor content that were macro- or micro-dissected from formalin-fixed, paraffin-embedded biopsy specimens. MicroRNAs in RNA from the biopsies and from resected tumors were quantified by TaqMan reverse transcription-polymerase chain reaction assays and normalized against the RNU6B housekeeping RNA. Publicly available microRNA expression datasets were examined.
NSCLC subtyping of small biopsy specimens by routine histopathologic examination either failed or mistyped the histology of 21% of 190 cases. Using 77 resectates, an reverse transcription-polymerase chain reaction-based assay of microRNAs miR-21, miR-205, and miR-375 was developed to identify AC and SCC subtypes of NSCLC. This method identified the AC/SCC histotypes of 25 biopsies with an accuracy of 96%, and correctly histotyped all 12 cases for which the histology had been mistyped by routine histopathologic examination of the biopsy. Examination of publicly available datasets identified miR-205 and miR-375 as microRNAs with the best ability to histotype AC and SCC, and that levels of the two microRNAs in AC or SCC are unaffected by the pathologic stage of the tumor or the age or race of the patient.
Histotypic microRNA assays can aid the subtyping of NSCLC biopsies as AC or SCC by standard histopathologic methods.
在活检中鉴别非小细胞肺癌(NSCLC)的腺癌(AC)和鳞状细胞癌(SCC)组织学类型在临床上具有重要意义,但常规组织病理学检查可能不准确。我们在一家癌症中心对这种不准确性进行了量化,并评估了一种基于微小RNA的方法在活检中对AC/SCC进行组织学分类的效用。
从福尔马林固定、石蜡包埋的活检标本中通过宏观或微观解剖获取肿瘤含量大于90%的组织切片,提取RNA。通过TaqMan逆转录-聚合酶链反应测定法对活检组织和切除肿瘤的RNA中的微小RNA进行定量,并以RNU6B管家RNA进行标准化。检查公开可用的微小RNA表达数据集。
通过常规组织病理学检查对小活检标本进行NSCLC亚型分类时,190例中有21%的病例组织学类型判断失败或错误。利用77例切除标本,开发了一种基于逆转录-聚合酶链反应的微小RNA miR-21、miR-205和miR-375检测方法,以鉴别NSCLC的AC和SCC亚型。该方法对25例活检标本的AC/SCC组织学类型进行了鉴别,准确率为96%,并正确地对所有12例经活检常规组织病理学检查组织学类型判断错误的病例进行了组织学分类。对公开可用数据集的检查确定miR-205和miR-375是对AC和SCC进行组织学分类能力最强 的微小RNA,并且这两种微小RNA在AC或SCC中的水平不受肿瘤病理分期、患者年龄或种族的影响。
组织学微小RNA检测可通过标准组织病理学方法辅助NSCLC活检标本区分为AC或SCC亚型。