Author of

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  P3.18 - Poster Session 3 - Pathology (ID 177)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Pathology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12784

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    P3.18-015 - <strong>The Utility of a Novel Triple Marker (combination of TTF, napsin-A and p40) in the Subclassification of Non-small Cell Lung Cancer (NSCLC).</strong> (ID 2911)

    09:30 - 09:30  |  Author(s): H. Zhang
    • Abstract

    Background
    Personalized treatment of lung cancers necessitates the subclassification of NSCLC into adenocarcinoma (ADC) and/or squamous cell carcinoma (SqCC). In most cases, NSCLC can be subclassified by routine histomorphological examination of tumors. However, in poorly differentiated tumors or on small biopsy specimens, the subclassification may be difficult by H&E slides alone. Therefore, a panel of immunehistochemical (IHC) markers, including TTF1, Napsin A for adenocarcinoma (ADC) and CK5/6, p63 and p40 for squamous cell carcinoma (SqCC), are usually used to aid in the subclassification, These panels need to be performed on multiple tissue sections, and may result in the exhaustion of tumor tissue for molecular tests. In order to preserve tumor tissue, we investigated the utility of a newly developed triple marker (a combination of TTF, Napsin A and p40) in the subclassification of NSCLC; and compared the sensitivity and specificity of this novel triple marker with commonly used individual markers.

    Methods
    Using pathology archives from Johns Hopkins Hospital, three lung cancer tissue microarrays (TMAs) were constructed using surgical resection material, including 77 cases of ADC, 75 cases of SqCC and 46 cases of metastatic lung ADC. Immunostaining patterns of the triple marker and individual markers were scored semi-quantitatively and compared.

    Results
    In ADC, the sensitivity and specificity of the triple marker showed 93.50% and 77.50%, respectively (Table 1). In SqCC, the sensitivity and specificity of the triple marker showed 100% and 92.50%, respectively (Table 2). In addition, the sensitivity and specificity of the triple marker in metastatic ADC showed 71.74% and 77.50%. Table 1. Immunostaining patterns of different markers in lung ADC (n=77 cases)

    	IHCscores
    Markers	0	1	2	3	Sensitivity	Specificity	P value
    Triple marker	6.5%	10.4%	13.0%	70.1%	93.5%	77.5%
    TTF	14.3%	5.2%	32.5%	48.1%	85.7%	75.0%	0.185
    Napsin A	10.4%	9.1%	22.1%	58.4%	89.6%	90.0%	0.564

    Table 2. Immunostaining patterns of different markers in lung SqCC (n=75 cases)

    	IHC scores
    Markers	0	1	2	3	Sensitivity	Specificity	P value
    Triple marker	0%	29.3%	33.3%	37.3%	100%	92.5%
    p40	0%	32.0%	29,3%	38.7%	100%	90.0%	1.0
    p63	0%	24.0%	45.3%	30.7%	100%	80.5%	1.0
    CK5/6	5.3%	22.7%	36.0%	36.0%	94.7%	80.0%	0.12

    Conclusion
    Our triple marker showed a similar specificity and sensitivity as individual markers and yielded optimal conservation of tissue for molecular testing.