Patel Trupti S, Shah Majal G, Gandhi Jahnavi S, Patel Pratik
Department of Pathology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India.
Diagn Cytopathol. 2017 Jul;45(7):598-603. doi: 10.1002/dc.23730. Epub 2017 Apr 21.
Sub typing of non small cell lung carcinoma (NSCLC) has an important task in the era of molecular and targeted therapies. Differentiating between squamous cell carcinoma (SQCC) and adenocarcinoma (ADC) is challenging when limited material is available in lung carcinoma. We investigated the accuracy and feasibility of sub typing NSCLCs in cytology and small biopsy material.
Concurrent cytology and biopsy material obtained in a single CT- guided procedure in lung carcinoma over a year period retrospectively. Both materials were individually sub typed and analyzed. Immunohistochemistry (IHC) was performed. Accuracy was determined by comparing the results with IHC.
Total 107 of 126 cases of NSCLCs were included for analysis, where both cytology and biopsy material were adequate for interpretation. FNAC allowed tumor typing in 83 (77.6%) cases; 36 (33.6%) were ADC, 47 (43.9%) cases were SQCC and 24 (22.4%) cases diagnosed as Non-small cell carcinoma not otherwise specified (NSCLC-NOS). In biopsy, 86 cases (80.4%) were typed, among which 34 (31.8%) were ADC, 52 (48.6%) were SQCC and 21 (19.6%) were of NSCLC-NOS type. The result of Chi-square index was significant. With the aid of IHC, NSCLC-NOS reduced from 14 (13%) cases to 2 (1.9%) cases.
Cytology and small biopsy specimens achieved comparable specificity and accuracy in sub-typing NSCLC and optimal results were obtain when findings from both modalities combine. The advantage of paired specimens is to maximize overall diagnostic yield and the remaining material will be available for ancillary technique like IHC or for molecular testing. Diagn. Cytopathol. 2017;45:598-603. © 2017 Wiley Periodicals, Inc.
在分子和靶向治疗时代，非小细胞肺癌（NSCLC）的亚型分类是一项重要任务。当肺癌中可用材料有限时，区分鳞状细胞癌（SQCC）和腺癌（ADC）具有挑战性。我们研究了在细胞学和小活检材料中对NSCLC进行亚型分类的准确性和可行性。
回顾性分析一年内通过单次CT引导下的操作在肺癌中同时获取的细胞学和活检材料。对两种材料分别进行亚型分类和分析。进行免疫组织化学（IHC）检测。通过与IHC结果比较来确定准确性。
126例NSCLC病例中共有107例纳入分析，其中细胞学和活检材料均足以进行解读。细针穿刺抽吸活检（FNAC）在83例（77.6%）病例中实现了肿瘤分型；36例（33.6%）为ADC，47例（43.9%）为SQCC，24例（22.4%）诊断为非特指的非小细胞癌（NSCLC-NOS）。在活检中，86例（80.4%）进行了分型，其中34例（31.8%）为ADC，52例（48.6%）为SQCC，21例（19.6%）为NSCLC-NOS型。卡方指数结果具有显著性。借助IHC，NSCLC-NOS从14例（13%）降至2例（1.9%）。
细胞学和小活检标本在NSCLC亚型分类中具有相当的特异性和准确性，当两种方法的结果相结合时可获得最佳结果。配对标本的优势在于最大化总体诊断率，剩余材料可用于IHC等辅助技术或分子检测。诊断细胞病理学。2017；45：598 - 603。©2017威利期刊公司。
