A comparison of diagnostic panels in the immunohistochemical analysis of lung cancer
Received 11 February 2019
Accepted for publication 23 July 2019
Published 11 September 2019 Volume 2019:11 Pages 7—15
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Melinda Thomas
Peer reviewer comments 2
Editor who approved publication: Dr Paul Zhang
Sarita Prabhakaran,1 Guang Xing,1 Ashleigh Hocking,1 Matthew Hussey,2 Douglas W Henderson,1,† Sonja Klebe1,2
1Department of Anatomical Pathology, Flinders University, Bedford Park, SA, Australia; 2Department of Anatomical Pathology, SA Pathology, Flinders Medical Centre, SA, Australia
†Professor Douglas Henderson passed away on September 17, 2018
Correspondence: Sonja Klebe
Department of Anatomical Pathology, Flinders Medical Centre and Flinders University, Bedford Park, SA 5042, Australia
Tel +61 088 204 3936
Fax +61 88 374 1437
Purpose: Classification of non-small cell lung carcinoma (NSCLC), as adenocarcinoma or squamous cell carcinoma, is important both in the diagnosis and treatment of lung cancer. Use of appropriate markers for this identification is crucial in order to conserve patient tissue for further molecular testing that could guide treatment decisions and have prognostic implications.
Patients and methods: We constructed tissue microarrays from archival resections of 200 NSCLC that were previously subtyped based on morphology and immunohistochemistry (IHC) in some cases. We performed IHC with three TTF-1 clones (SP141, SPT24 and 8G7G3/1), Napsin A, p40, p63 and CK5/6 and panels of four or two markers that best help identify adenocarcinoma and squamous cell carcinoma were ascertained.
Results: Our results showed that the best four-marker panel utilized TTF-1 (clone SP141), Napsin A, p63 and CK5/6 with a sensitivity of 98.3% and high specificity of 91.7%. The best two-marker panel was TTF-1 (clone SP141) and p63 with 96.5% sensitivity and 85.71% specificity.
Conclusion: As there are variations in the performance of different clones of TTF-1 IHC antibodies, the clone chosen can increase the diagnostic value in differentiating adenocarcinoma from squamous cell carcinoma. In the panels analyzed, the survival of cases concordant with the diagnosis had longer survival compared to those that were discordant. The difference was however not statistically significant (p>0.05).
Keywords: non-small cell lung carcinoma, immunohistochemistry, squamous cell carcinoma, adenocarcinoma
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