Fine-needle aspiration cytology of non-small cell lung carcinoma: A paradigm shift

Diagn Cytopathol. 2019 Apr;47(4):351-358. doi: 10.1002/dc.24089. Epub 2018 Nov 29.

Abstract

Lung carcinoma is one of the commonest causes of cancer related death. Fine-needle aspiration cytology (FNAC) is a well-established technique in the diagnosis of various malignant tumors. FNAC is now an important technique in classifying lung carcinomas and also detecting salient mutational changes in lung carcinomas. The judicious use of the various immunological markers such as TTF-1, p40, CK 5/6, CK 7 and Napsin may help in sub-classification of non-small cell lung carcinomas (NSCLC). The mutational changes in epidermal growth factor receptor (EGFR) and ALK genes are needed in targeted therapy of adenocarcinoma of lung. With the help of immunocytochemistry, polymerase chain receptor, fluorescent in situ hybridization and next generation sequencing, one can detect various mutational changes in NSCLC. In this review article, we have discussed the role of cytology and other ancillary techniques to classify lung carcinomas. The important mutational changes in lung carcinoma for targeted therapy have also been discussed in detail.

Keywords: ALK rearrangement; EGFR mutation; FNAC; Napsin; PD L1; ROS 1 mutation; TTF-1; classification of lung carcinoma; lung; targeted therapy in lung carcinoma.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / genetics*
  • Biomarkers, Tumor / metabolism
  • Biopsy, Fine-Needle / methods
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / metabolism
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Humans
  • Lung Neoplasms / genetics
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / pathology*
  • Mutation

Substances

  • Biomarkers, Tumor