Zhao LinLin, Ma HaiYue, Sun Yue, Wang Cong, Chang XinXiang, Guo HuiQin, Zhao Huan, Zhang ZhiHui
Cytopathology Section, Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Diagn Cytopathol. 2023 Jun;51(6):365-373. doi: 10.1002/dc.25123. Epub 2023 Mar 11.
This study aims to investigate the feasibility and reliability of ThinPrep slides in detecting the subclassification of lung cancer and develop a process for immunocytochemistry (ICC) with optimized staining steps of an automated immunostainer.
Cytomorphology and ancillary ICC by automated immunostainer on ThinPrep slides were performed to subclassify 271 cytology cases of pulmonary tumor, which were stained with 2 or more of the following antibodies: p40, p63, thyroid transcription factor-1 (TTF-1), Napsin A, synaptophysin (Syn), and CD56.
The accuracy of cytological subtyping was improved from 67.2% to 92.7% (p < .0001) after ICC. The accuracy of cytomorphology combined with ICC results for lung squamous-cell carcinoma (LUSC), lung adenocarcinomas (LUAD), and small cell carcinoma (SCLC) was 89.5% (51 of 57), 97.8% (90 of 92), and 98.8% (85 of 86), respectively. The sensitivity and specificity of 6 antibodies were as follows: p63 (91.2%, 90.4%) and p40 (84.2%, 95.1%) for LUSC, TTF-1(95.6%, 64.6%) and Napsin A (89.7%, 96.7%) for LUAD and Syn (90.7%, 60.0%) and CD56 (97.7%, 50.0%) for SCLC, respectively. P40 expression on ThinPrep slides had the highest agreement (κ = 0.881) with immunohistochemistry (IHC) results, followed by p63 (κ = 0.873), Napsin A (κ = 0.795), TTF-1 (κ = 0.713), CD56 (κ = 0.576), and Syn (κ = 0.491).
The result of ancillary ICC on ThinPrep slides by fully automated immunostainer was in good agreement with the gold standard in pulmonary tumors subtype and immunoreactivity, objectively achieving accurate subtyping in cytology.
本研究旨在探讨ThinPrep玻片在检测肺癌亚型方面的可行性和可靠性，并开发一种免疫细胞化学（ICC）流程，优化自动免疫染色仪的染色步骤。
对271例肺肿瘤细胞学病例进行细胞形态学检查，并通过自动免疫染色仪在ThinPrep玻片上进行辅助ICC，用以下2种或更多抗体进行染色：p40、p63、甲状腺转录因子-1（TTF-1）、Napsin A、突触素（Syn）和CD56。
ICC后细胞学亚型分类的准确率从67.2%提高到92.7%（p < 0.0001）。肺鳞状细胞癌（LUSC）、肺腺癌（LUAD）和小细胞癌（SCLC）的细胞形态学与ICC结果结合的准确率分别为89.5%（57例中的51例）、97.8%（92例中的90例）和98.8%（86例中的85例）。6种抗体的敏感性和特异性如下：LUSC的p63（91.2%，90.4%）和p40（84.2%，95.1%），LUAD的TTF-1（95.6%，64.6%）和Napsin A（89.7%，96.7%），SCLC的Syn（90.7%，60.0%）和CD56（97.7%，50.0%）。ThinPrep玻片上的p40表达与免疫组织化学（IHC）结果的一致性最高（κ = 0.881），其次是p63（κ = 0.873）、Napsin A（κ = 0.795）、TTF-1（κ = 0.713）、CD56（κ = 0.576）和Syn（κ = 0.491）。
全自动免疫染色仪在ThinPrep玻片上进行辅助ICC的结果与肺肿瘤亚型和免疫反应性的金标准高度一致，客观上实现了细胞学的准确亚型分类。
