Comparison of Programmed Death Ligand-1 Immunohistochemical Staining Between Endobronchial Ultrasound Transbronchial Needle Aspiration and Resected Lung Cancer Specimens

Sakata, Keiko; Midthun, David E.; Mullon, John J.; Kern, Ryan; Nelson, Darlene R.; Edell, Eric S.; Schiavo, Dante; Jett, James R.; Aubry, Marie Christine

doi:10.1016/j.chest.2018.07.017

Cited by 57 publications

(49 citation statements)

References 36 publications

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“…PD-L1 staining on cell blocks from EBUS-TBNA has been shown to be consistent with that of corresponding resected primary tumour specimens [53]. We did not study the use of smears for PD-L1 staining, but emerging data suggest its feasibility and equivalence with core biopsy samples [54, 55].…”

Section: Discussionmentioning

confidence: 99%

Diff-Quik Cytology Smears from Endobronchial Ultrasound Transbronchial Needle Aspiration Lymph Node Specimens as a Source of DNA for Next-Generation Sequencing Instead of Cell Blocks

et al. 2019

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Background: Next-generation sequencing (NGS) in lung cancer specimens from endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is usually performed on formalin-fixed paraffin-embedded cell block material. Objectives: Since DNA can be damaged by this process, we investigated the potential of using DNA extracted from Diff-Quik cytology smears made for rapid on-site evaluation during EBUS-TBNA. Methods: In a prospective study, 67 patients undergoing diagnostic EBUS-TBNA were analysed. We compared cell blocks and smears for DNA yields and sequencing (TruSeq Amplicon Cancer Panel) outcomes. Smears were also evaluated for tumour cell fraction and overall cellularity (cell count). Results: Primary lung cancer was diagnosed in 64 patients and metastatic malignancy in 3 patients. The DNA yield from smears was significantly higher than that obtained from matched cell blocks (mean 1,740 vs. 434 ng; p = 0.001). For 33 cases with matched smears and cell blocks the mutation profiles were similar. Smears with abundant malignant cells (using a cut-off of > 25% tumour cell fraction and > 1,000 cells) accurately predicted high (> 50 ng) DNA yield and therefore success in triaging samples to sequencing. In terms of tissue workflow, using only smears as source DNA for sequencing was an improvement in the use of only cell blocks (54/67 [80.6%] vs. 41/67 [61.2%]); however, the use of cell blocks when smears were not available or did not yield sufficient DNA further improved the success rate to 62/67 (92.5%) cases. Conclusion: We recommend smears in laboratory workflows as the primary source of DNA for NGS following an EBUS procedure.

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Section: Discussionmentioning

confidence: 99%

Diff-Quik Cytology Smears from Endobronchial Ultrasound Transbronchial Needle Aspiration Lymph Node Specimens as a Source of DNA for Next-Generation Sequencing Instead of Cell Blocks

et al. 2019

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“…Nine studies were eligible for analysis of concordance between matched cytology and histology specimens with PD-L1 expression data based on staining on TCs (Tables 2 and 3) [24,25,28,[31][32][33][34][35][36]. Across the nine studies identified, the OPA for cytology and histology specimens (n = 428) was 88.3 % (95 % CI: 86.9-91.2) and 89.7 % (95 % CI: 86.5-92.4) for specimens with ≥1 % and ≥50 % of TCs expressing PD-L1, respectively.…”

Section: Concordance Analysismentioning

confidence: 99%

Cytology for PD-L1 testing: A systematic review

et al. 2020

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Evaluation of tumoral programmed cell death ligand-1 (PD-L1) expression is standard practice for patients with advanced non-small-cell lung cancer (NSCLC) who may be candidates for treatment targeting the programmed cell death-1 (PD-1)/PD-L1 pathway. Currently, all of the commercially available immunohistochemistry assays have been validated for use with histology specimens although, in routine clinical practice, approximately 30-40 % of patients with advanced NSCLC have only cytology specimens available for diagnosis, staging, and biomarker analysis. This systematic review evaluated the success rate, concordance, and clinical utility of using cytology specimens to assess tumor PD-L1 expression levels compared with histology specimens from patients with advanced NSCLC. EMBASE and PubMed database searches identified 142 unique, relevant publications, of which 15 met the inclusion criteria for at least one analysis. In 709 specimens, across seven publications, the proportion of cytology specimens evaluable for PD-L1 testing was 92.0 %. Among nine studies eligible for concordance analysis between cytology and histology specimens at a PD-L1 tumor cell expression cutoff of ≥50 %, overall percentage agreement was 89.7 % (n = 428), 72.0 % for positive percentage agreement (n = 218), and 95.0 % for negative percentage agreement (n = 258); results using a tumor PD-L1 expression cutoff of ≥1 % were similar. Our analyses suggest that using cytology specimens to assess PD-L1 expression is feasible, with good levels of concordance between cytology and histology specimens using PD-L1 tumor cell expression cutoffs of ≥1 % and ≥50 %. In conclusion, there is no convincing evidence that cytology specimens are inadequate or inferior to histology specimens for assessing PD-L1 expression in patients with NSCLC.

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“…Accordingly, cytological samples may represent the PD-L1 expression lesser than expected because of the diameter in T3 and T4 tumors. In a study conducted by Sakata et al (19), the EBUS needle aspiration was compared to tumor resection. This is supported by the fact that cytological samples are less sensitive than large tissues.…”

Section: Resultsmentioning

confidence: 99%

Programmed Death-ligand 1 Expression Analysis for Non-small Cell Lung Cancer in Tissues Sampled Using Different Methods

Ürer¹,

Günlüoğlu²,

Cansever³

et al. 2020

Haseki

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This study aims at investigating the concordance of programmed death-ligand 1 (PD-L1) expression in non-small cell cancer tissues that have been sampled using different methods and its relationship with the pathologic parameters of tumors. Methods: PD-L1 expression assays were made on the cell blocks taken using fine needle aspiration, the small tissue samples representing endoscopic biopsy and the large tissue samples representing the resected tumor taken from the tumors of 100 subjects diagnosed with non-small cell lung cancer; their percentage values were evaluated and their groups were determined based on these values. Results: The average difference in expression rates found through different sampling methods was close to 0, and the values of such differences changed mostly in a narrow range. In paired comparisons, a good level of concordance was observed between all the sampling methods. The values were 0.8865 (SE: 0.0306, CI: 0.8264-0.9466) in the comparison of tumor tissue (TT) and small biopsy (SB): 0.8637, (SE: 0.033, CI: 0.7989-0.9285) TT to cell block (CB): 0.8916, (SE: 0.0272, CI: 0.8383-0.9449) SB tissue to the CB. Conclusion: Therefore, it can be concluded that the PD-L1 expression does not differ between the tissues sampled through various methods in non-small cell lung cancers.

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Comparison of Programmed Death Ligand-1 Immunohistochemical Staining Between Endobronchial Ultrasound Transbronchial Needle Aspiration and Resected Lung Cancer Specimens

Cited by 57 publications

References 36 publications

Diff-Quik Cytology Smears from Endobronchial Ultrasound Transbronchial Needle Aspiration Lymph Node Specimens as a Source of DNA for Next-Generation Sequencing Instead of Cell Blocks

Diff-Quik Cytology Smears from Endobronchial Ultrasound Transbronchial Needle Aspiration Lymph Node Specimens as a Source of DNA for Next-Generation Sequencing Instead of Cell Blocks

Cytology for PD-L1 testing: A systematic review

Programmed Death-ligand 1 Expression Analysis for Non-small Cell Lung Cancer in Tissues Sampled Using Different Methods

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