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H. Nanjo
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P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.04-011 - Intraoperative Diagnosis of Lymph Node Metastasis Using a Rapid-Immunohistochemical (R-IHC) Staining Method in Non-Small Cell Lung Cancer (ID 912)
09:30 - 09:30 | Author(s): H. Nanjo
- Abstract
Background:
Nodal micrometastasis in non-small cell lung cancer (NSCLC) is associated with a poorer survival rate than node-negative disease. Furthermore, lymph node micrometastasis often cannot be detected using conventional hematoxylin and eosin staining of frozen sections; detection requires additional time-consuming immunohistochemical (IHC) analysis of paraffin-embedded tissue. We developed a novel ultrarapid immunohistochemical staining method in which an AC electric field is used to facilitate detection of tumor cells. This method allows detection of tumor cells in frozen sections in less than 20 min, and could be a useful tool for frozen diagnosis. We previously reported IHC analysis for NSCLC in detection of lymph node micrometastasis without misdiagnosis using the rapid-IHC protocol developed at our institute. This technology, which has been patented, was released in May 2014 as "Histotech-R-IHC[R]". The purpose of rapid-IHC analysis during surgery for NSCLC is the utility of intraoperative diagnosis of lymph node metastasis.
Methods:
Thirty-four patients with NSCLC were enrolled in the study between June 2014 and March 2015 after obtaining signed informed consent. Surgery was performed at Akita University School of Medicine and University Hospital. The patients were taken to an operating room, and the standard preparations were made for a thoracotomy and lung resection such as lobectomy with systematic/selective nodal dissection or segmentectomy. Dissected lymph nodes from each patient were used in this study. Intraoperative samples from dissected lymph nodes were sectioned, conventionally stained with HE, and immunohistochemically labeled with anti-CK (AE1/AE3) antibody using the rapid-IHC procedures, after which they were examined by a pathologist.
Results:
IHC analyses were completed within 20 min, and the diagnosis was made by the pathologist within about 30 min. Two patients were diagnosed as positive on the basis of conventional histological examination, and the same two patients were deemed positive on the basis of CK detection using rapid-IHC. There were no micrometastases in this study. All patients diagnosed as negative based on CK detection using rapid-IHC were pathologically N0. Twenty-one patients underwent lobectomy, and 13 patients received segmentectomy. Twenty-eight patients underwent lymph node dissection of hilar and mediastinal (ND2a) nodes, and six patients underwent lymph node dissection of hilar nodes only (ND1).
Conclusion:
The rapid-IHC device is useful for intraoperative diagnosis of lymph node metastasis in lung cancer surgery. We want to apply this method to the minimally invasive surgery selection such as segmentectomy and selective mediastinal lymph node dissection. Further investigation in multicenter studies will be needed to confirm the utility of this method.
