Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands.
Department of Surgery, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands; Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
Ann Diagn Pathol. 2023 Dec;67:152181. doi: 10.1016/j.anndiagpath.2023.152181. Epub 2023 Jul 17.
Primary diagnosis of bronchial carcinoids (BC) is always made on biopsies and additional immunohistochemistry (IHC) is often necessary. In the present study we investigated the concordance of common diagnostic (synaptophysin, chromogranin, CD56 and INSM-1) and potential prognostic (OTP, CD44, Rb and p16) IHC markers between the preoperative biopsies and resections of in total 64 BCs, 26 typical (41 %) and 38 atypical (59 %) carcinoid tumors. Synaptophysin and chromogranin had 100 % concordance in all resected carcinoids and paired diagnostic biopsies. Synaptophysin was not affected by variable expression in biopsies compared to chromogranin, CD56 and INSM-1. Notably, INSM-1 IHC was false negative in 8 % of biopsies. Of the novel and potential prognostic markers, only CD44 showed 100 % concordance between biopsies and resections, while OTP showed two (4 %) false negative results in paired biopsies. While Rb IHC was false negative in 8 % of biopsies, no strong and diffuse pattern of p16 expression was observed. In this study, most false negative IHC results (85 %, 22/26) were observed in small flexible biopsies. Taken together, our data suggest excellent concordance of synaptophysin and CD44 on the preoperative biopsy samples, while other neuroendocrine markers, Rb and OTP should be interpreted with caution, especially in small biopsies.
原发性支气管类癌（BC）的诊断通常基于活检，并且通常需要额外的免疫组织化学（IHC）检查。在本研究中，我们研究了术前活检和总共 64 例 BC 切除标本中常见诊断（突触素、嗜铬粒蛋白、CD56 和 INSM-1）和潜在预后（OTP、CD44、Rb 和 p16）IHC 标志物之间的一致性，其中 26 例为典型（41%），38 例为非典型（59%）类癌肿瘤。在所有切除的类癌和配对诊断活检中，突触素和嗜铬粒蛋白的一致性为 100%。与嗜铬粒蛋白、CD56 和 INSM-1 相比，突触素在活检中的表达变化不受影响。值得注意的是，INSM-1 IHC 在 8%的活检中呈假阴性。在新型和潜在的预后标志物中，只有 CD44 在活检和切除标本之间具有 100%的一致性，而 OTP 在配对活检中显示出 2%（4%）的假阴性结果。虽然 Rb IHC 在 8%的活检中呈假阴性，但未观察到 p16 表达的强烈和弥漫模式。在这项研究中，大多数假阴性 IHC 结果（85%，22/26）出现在小而灵活的活检中。综上所述，我们的数据表明突触素和 CD44 在术前活检标本上具有极好的一致性，而其他神经内分泌标志物 Rb 和 OTP 的结果应谨慎解释，尤其是在小活检中。
