Complementary value of electron microscopy and immunohistochemistry in the diagnosis of non-small cell lung cancer: A potential role for electron microscopy in the era of targeted therapy. (2nd November 2019)

• Record Type: Journal Article
• Authors: Albero-González, Raquel; Munné-Collado, Jessica; Pijuan, Lara; Simón, Mercedes; Gimeno-Beltrán, Javier; Mojal, Sergi; Salido, Marta; Clavé, Sergi; Juanpere, Nuria; Dalmases, Alba; Comerma, Laura; Vázquez, Ivonne; Sánchez-Font, Albert; Taus, Álvaro; Hernández, Silvia; Lloveras, Belén; Lloreta Trull, Josep
• Is Part Of: Ultrastructural pathology. Volume 43:Number 6(2019)
• Page Start: 237
• Page End: 247
• Publication Date: 2019-11-02
• Subjects: Non-small cell lung carcinoma -- Not otherwise specified (NSCLC-NOS) -- Adenocarcinoma (ADC) -- Squamous Cell Carcinoma (SCC) -- Immunohistochemistry (IHC) -- Electron microscopy (EM) -- Targeted therapy; Pathology, Cellular -- Periodicals; Ultrastructure (Biology) -- Periodicals; Diagnosis, Electron microscopic -- Periodicals; Microscopy, Electron; Pathology; 616.07582
• DOI: 10.1080/01913123.2019.1692118
• Languages: English
• ISSNs: 0191-3123

Abstract

ABSTRACT: With the identification of therapeutic targets for lung adenocarcinoma, it has become mandatory to distinguish it from other entities. Some cases remain classified as non-small cell lung carcinoma, not otherwise specified (NSCLC-NOS) with immunohistochemistry. Electron microscopy (EM) can be useful, allowing the identification of glandular differentiation. The aim of this study was to determine the complementary value of immunohistochemistry and EM. Forty-eight NSCLC-NOS cases were selected (PSMAR-Biobank, Barcelona, Spain). Immunohistochemistry (TTF-1, p40) was performed. Tissue was retrieved from paraffin blocks. Results were compared to the final diagnosis, derived from combination of light microscopy, immunohistochemistry, EM, molecular studies and resection specimen. Immunohistochemistry concurred with final diagnosis in 36 cases (75%, Kappa = 0.517). EM agreed with final diagnosis in 35 (72.9%, Kappa = 0.471). Immunohistochemistry had a sensitivity = 73%, specificity = 100%, positive predictive value (PPV) = 100% and negative predictive value (NPV) = 52.4% for adenocarcinoma. All adenocarcinoma cases not solved by immunohistochemistry (n = 10) were classified by EM, and vice versa. Data from EM were identical to those of immunohistochemistry: sensitivity = 73%, specificity = 100%, PPV = 100% and NPV = 52.4%. Combining both techniques, 47 cases were coincident with final diagnosis (97.9%, Kappa = 0.943). EM can provide valuable information in subtyping NSCLC-NOS, being particularly useful when immunohistochemistry is inconclusive. EM could be considered as a complementary tool for decision-making in NSCLC-NOS.