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Predictive immunocytochemistry of NSCLC - results in 2019.

In the era of targeted therapy, predictive biomarker testing has become increasingly important for nonsmall cell lung cancer. Immunocyto/histochemistry is widely available and technically less challenging, can provide clinically meaningful results with rapid turn- around-time and is more cost efficient than molecular platforms. Several immunocyto/histochemical assays for predictive biomarkers have already been implemented in routine cytology/pathology practice. We presented archive records of our one-year NSCLC predictive immunocytochemistry results. Our predictive ICC assays including ALK (anaplastic lymphoma kinase), ROS1 (proto-oncogene tyrosine-protein kinase) and PD-L1 (programmed death-ligand1) performed on cytological slides of our institution patients (1168 monoclonal antibodies) and on cytological slides of the patients of others University Hospitals Centers and General Hospitals (679 monoclonal antibodies). Cytological specimens used for ICC including bronhoscopic samples (bronchial washings/brushings, transbronchial FNA), pleural effusions, FNA of peripheral lymph nodes and skin nodules, transthoracic FNA/biopsy and some cell- block samples. PD-L1 protein expression was scored using Tumor Proportion Score (TPS) with positive cut-off of ≥1% , membrane staining. Cytological smear wih ≥100 tumor cells were required for test adequacy. The slides were routinely examined and scored by two cytologists. Internal and external quality control were performed on FFPE cell blocks and histology slides with coresponding Ventana antibodies and staining systems. We have 1847 ICC results on air dried cytological smears and cytospins of NSCLC samples stained with anti-ALK Clone D5F3, Cell Signaling, appendix positive control ; anti-ROS1 Clone D4D6 Cell Signaling, HCC-78 cell line positive control, and anti-PD-L1, Clone 22C3, Dako, placenta imprint positive control ; EnVision detection system on Immunocytochemistry Autostainer. Out of 1847 samples, 163 (8.82%) were inadequate and 1684(91.2%%) adequate. ALK was positive in total of 16/503 (3.18%) samples. ROS1 was positive in total of 6/492 (1, 21%). PD-L1 was positive in total of 404/689 (58.6%) samples. PD-L1 scores positive <50 in 201 (29.17%) samples and PD-L1 scored ≥50% in 203 (29.46.7%) samples. Percent of inadequate samples were 7.8% for our patients and 10.6% for patients from other institutions. Our results of predictive ICC are comparable with other studies, shows reproducibility and accuracy.

NSCLC ; predictive immunocytochemistry ; university hospital center ; results

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