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J Thorac Oncol. 2019 Mar;14(3):377-407. doi: 10.1016/j.jtho.2018.12.005. Epub 2018 Dec 18.

Best Practices Recommendations for Diagnostic Immunohistochemistry in Lung Cancer.

Author information

1
Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan. Electronic address: yyatabi@aichi-cc.jp.
2
Department of Pathology University of Pittsburgh, Pittsburgh, Pennsylvania.
3
Department of Pathology, Weill Cornell Medicine, New York, New York.
4
Institute of Pathology, Cytopathology, and Molecular Pathology MVZ UEGP Giessen, Wetzlar, Limburg, Germany.
5
Anatomical Pathology Department, St. Vincent's Hospital and the University of Melbourne, Fitzroy, Victoria, Australia.
6
Department of Biopathology, Centre Léon Bérard, Grenoble Alpes University, Lyon, France.
7
Department of Pathology, Mount Sinai Medical Center, New York, New York.
8
Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
9
Department of Oncology and Hemato-Oncology, University of Milan and IRCCS MultiMedica, Milan, Italy.
10
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
11
Institute of Pathology, University Hospital Basel, Basel, Switzerland.
12
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
13
Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.
14
Department of Pathology, The University of Mississippi Medical Center, Jackson, Mississippi.
15
Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, Tsukuba, Japan.
16
Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
17
Department of Immunology Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
18
Department of Pathology and Respiratory Center, Seoul National University Bundang Hospital, Seongnam city, Gyeonggi- do, Republic of Korea.
19
Division of Molecular Pathology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Republic of China.
20
Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
21
Office of Pathology Consultants, Buenos Aires, Argentina.
22
Laboratorio de Dianas Terapeuticas, Hospital Universitario HM Sanchinarro, Madrid, Spain.
23
Department of Oncology, University of Turin, Turin, Italy.
24
Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Minnesota.
25
University of Colorado Anschutz Medical Campus, Aurora, Colorado.
26
Department of Pathology, Aberdeen Royal Infirmary, Aberdeen University Medical School, Aberdeen, Scotland, United Kingdom.
27
Department of Pathology, University Health Network/Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
28
Department of Histopathology, Royal Brompton and Harefield National Health Service Foundation Trust and National Heart and Lung Institute, Imperial College, London, United Kingdom.
29
Department of Translational Molecular Pathology, M. D. Anderson Cancer Center, Houston, Texas.
30
Department of Pathology, New York University Langone Health, New York, New York.

Abstract

Since the 2015 WHO classification was introduced into clinical practice, immunohistochemistry (IHC) has figured prominently in lung cancer diagnosis. In addition to distinction of small cell versus non-small cell carcinoma, patients' treatment of choice is directly linked to histologic subtypes of non-small cell carcinoma, which pertains to IHC results, particularly for poorly differentiated tumors. The use of IHC has improved diagnostic accuracy in the classification of lung carcinoma, but the interpretation of IHC results remains challenging in some instances. Also, pathologists must be aware of many interpretation pitfalls, and the use of IHC should be efficient to spare the tissue for molecular testing. The International Association for the Study of Lung Cancer Pathology Committee received questions on practical application and interpretation of IHC in lung cancer diagnosis. After discussions in several International Association for the Study of Lung Cancer Pathology Committee meetings, the issues and caveats were summarized in terms of 11 key questions covering common and important diagnostic situations in a daily clinical practice with some relevant challenging queries. The questions cover topics such as the best IHC markers for distinguishing NSCLC subtypes, differences in thyroid transcription factor 1 clones, and the utility of IHC in diagnosing uncommon subtypes of lung cancer and distinguishing primary from metastatic tumors. This article provides answers and explanations for the key questions about the use of IHC in diagnosis of lung carcinoma, representing viewpoints of experts in thoracic pathology that should assist the community in the appropriate use of IHC in diagnostic pathology.

KEYWORDS:

Immunohistochemistry; Lung cancer; Neuroendocrine markers; TTF1; p40

PMID:
30572031
PMCID:
PMC6422775
[Available on 2020-03-01]
DOI:
10.1016/j.jtho.2018.12.005

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