Triple marker composed of p16, CD56, and TTF1 shows higher sensitivity than INSM1 for diagnosis of pulmonary small cell carcinoma: proposal for a rational immunohistochemical algorithm for diagnosis of small cell carcinoma in small biopsy and cytology specimens
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články
PubMed
30385371
DOI
10.1016/j.humpath.2018.10.016
PII: S0046-8177(18)30413-1
Knihovny.cz E-zdroje
- Klíčová slova
- Cytology, INSM1, Immunohistochemistry, Small cell lung cancer, p16,
- MeSH
- algoritmy MeSH
- antigen CD56 metabolismus MeSH
- biopsie MeSH
- DNA vazebné proteiny metabolismus MeSH
- dospělí MeSH
- imunohistochemie MeSH
- inhibitor p16 cyklin-dependentní kinasy metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- malobuněčný karcinom plic diagnóza metabolismus patologie MeSH
- nádorové biomarkery metabolismus MeSH
- nádory plic diagnóza metabolismus patologie MeSH
- represorové proteiny metabolismus MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- transkripční faktory metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antigen CD56 MeSH
- CDKN2A protein, human MeSH Prohlížeč
- DNA vazebné proteiny MeSH
- inhibitor p16 cyklin-dependentní kinasy MeSH
- INSM1 protein, human MeSH Prohlížeč
- nádorové biomarkery MeSH
- represorové proteiny MeSH
- transkripční faktory MeSH
- TTF1 protein, human MeSH Prohlížeč
Pulmonary small cell carcinoma (SCLC) can be usually diagnosed based on the morphological evaluation of routine histological or cytological preparations. However, immunohistochemistry may be also necessary in problematic cases. Insulinoma-associated 1 (INSM1) has recently been reported as a highly sensitive and specific marker that displays positivity in ~90%-100% of poorly differentiated pulmonary neuroendocrine tumors. We compared diagnostic performance of INSM1 and previously reported composite marker CD56 + p16 + thyroid transcription factor-1 (TTF1) in the diagnosis of SCLC in small biopsy specimens and cytoblocks. The composite marker CD56 + p16 + TTF1 correctly classified 100% of SCLC cases, and its sensitivity was significantly higher than the sensitivity of INSM1. Among 100 SCLC cases, CD56, TTF1, and p16 each individually classified more specimens correctly than INSM1 (CD56: 84%, TTF1: 89%, p16: 95%, INSM1: 81%); the difference was statistically significant only for p16. INSM1 showed the lowest classification agreement between paired biopsy and cytoblock specimens (κ = 0.182), whereas CD56 and p16 displayed perfect agreement (κ = 1) and TTF1 showed moderate agreement (κ = 0.4). Although INSM1 is reportedly the most specific marker of SCLC, its sensitivity is not superior to p16 or composite marker CD56 + TTF1 + p16. Based on this study, we propose the following algorithm, which, in the appropriate clinical and histological context, may be useful in establishing the correct diagnosis of SCLC: First, INSM1 detection is performed, and if the result is negative, CD56 is added, followed successively by p16 and TTF1 if all previously applied markers are negative. This approach should detect most, if not all, SCLC cases, while successively trading specificity for sensitivity.
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