Abstract
The insufficiency of classifing lung cancer as SCLC or NSCLC clinical arose with the approval of the antifolate pemetrexed, which has a lower antitumorous effectivity in Squamous Cell Carcinoma. Often only biopsy specimens are available to exclude a squamous differentiation before chemotherapy decision.
The restrictive nature of subtyping lung cancer in biopsies demanded a skilled and experienced pathologist. This interlaboratory comparison should discover the accordance of subtyping of lung cancer biopsies evaluated in 5 different pathological institutes in germany. Is it possible to improve the accuracy histological typing by additional immunhistochemistry (IHC) panel?
60 biopsy specimens with Hematoxylin-eosin (HE) stain and immunhistological stained slides of at least Ck7, Ck5/6, p63, TTF1 were assembled and analysed from the pathologists. An estimation of predominantly-non-squamous yes/no and the histological subtype was done after examination the HE slide and again after the examination of the IHC. These two results were compared.
All 60 cases were analysed by all 5 participants. In average the agreement of predominantly-non-squamous with inspecting the HE slide was 50% and arose after IHC to 87%. The accordance of histological subtype arose from 58% after HE slide to 88% after IHC.
Histological subtyping of lung cancer biopsies can be done reliably with the help of an immunhistochemical panel of CK5/6, CK7, TTF1 and p63. Thus, we recommend the use of IHC to ensure diagnosis of lung cancer biopsies especially for patients coming into consideration for pemetrexed chemotherapy.
- © 2011 ERS
