Molecular testing guidelines for lung adenocarcinoma

Utility of cell blocks and concordance between fine-needle aspiration cytology and histology samples

Jonas Heymann, William Bulman, Roger Maxfield, Charles Powell, Balazs Halmos, Joshua Sonett, Nike Beaubier, John Crapanzano, Mahesh Mansukhani, Anjali Saqi

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Lung cancer is a leading cause of mortality, and patients often present at a late stage. More recently, advances in screening, diagnosing, and treating lung cancer have been made. For instance, greater numbers of minimally invasive procedures are being performed, and identification of lung adenocarcinoma driver mutations has led to the implementation of targeted therapies. Advances in molecular techniques enable use of scant tissue, including cytology specimens. In addition, per recently published consensus guidelines, cytology-derived cell blocks (CBs) are preferred over direct smears. Yet, limited comparison of molecular testing of fine-needle aspiration (FNA) CBs and corresponding histology specimens has been performed. This study aimed to establish concordance of epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (KRAS) virus homolog testing between FNA CBs and histology samples from the same patients. Materials and Methods: Patients for whom molecular testing for EGFR or KRAS was performed on both FNA CBs and histology samples containing lung adenocarcinoma were identified retrospectively. Following microdissection, when necessary, concordance of EGFR and KRAS molecular testing results between FNA CBs and histology samples was evaluated. Results: EGFR and/or KRAS testing was performed on samples obtained from 26 patients. Concordant results were obtained for all EGFR (22/22) and KRAS (17/17) mutation analyses performed. Conclusions: Identification of mutations in lung adenocarcinomas affects clinical decision-making, and it is important that results from small samples be accurate. This study demonstrates that molecular testing on cytology CBs is as sensitive and specific as that on histology.

Original languageEnglish (US)
Article number12
JournalCytoJournal
Volume11
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Fine Needle Biopsy
Cell Biology
Histology
Guidelines
Epidermal Growth Factor Receptor
Sarcoma
Mutation
Lung Neoplasms
Kirsten murine sarcoma virus
Microdissection
Parvovirus
Adenocarcinoma of lung
Mortality

Keywords

  • Cell blocks
  • cytopathology
  • endobronchial ultrasound-guided
  • epidermal growth factor receptor
  • fine needle aspiration
  • Kirsten rat sarcoma
  • lung adenocarcinoma
  • molecular testing

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Molecular testing guidelines for lung adenocarcinoma : Utility of cell blocks and concordance between fine-needle aspiration cytology and histology samples. / Heymann, Jonas; Bulman, William; Maxfield, Roger; Powell, Charles; Halmos, Balazs; Sonett, Joshua; Beaubier, Nike; Crapanzano, John; Mansukhani, Mahesh; Saqi, Anjali.

In: CytoJournal, Vol. 11, No. 1, 12, 01.01.2014.

Research output: Contribution to journalArticle

Heymann, Jonas ; Bulman, William ; Maxfield, Roger ; Powell, Charles ; Halmos, Balazs ; Sonett, Joshua ; Beaubier, Nike ; Crapanzano, John ; Mansukhani, Mahesh ; Saqi, Anjali. / Molecular testing guidelines for lung adenocarcinoma : Utility of cell blocks and concordance between fine-needle aspiration cytology and histology samples. In: CytoJournal. 2014 ; Vol. 11, No. 1.
@article{b804fe1dbf38461382d8677ff265fb02,
title = "Molecular testing guidelines for lung adenocarcinoma: Utility of cell blocks and concordance between fine-needle aspiration cytology and histology samples",
abstract = "Background: Lung cancer is a leading cause of mortality, and patients often present at a late stage. More recently, advances in screening, diagnosing, and treating lung cancer have been made. For instance, greater numbers of minimally invasive procedures are being performed, and identification of lung adenocarcinoma driver mutations has led to the implementation of targeted therapies. Advances in molecular techniques enable use of scant tissue, including cytology specimens. In addition, per recently published consensus guidelines, cytology-derived cell blocks (CBs) are preferred over direct smears. Yet, limited comparison of molecular testing of fine-needle aspiration (FNA) CBs and corresponding histology specimens has been performed. This study aimed to establish concordance of epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (KRAS) virus homolog testing between FNA CBs and histology samples from the same patients. Materials and Methods: Patients for whom molecular testing for EGFR or KRAS was performed on both FNA CBs and histology samples containing lung adenocarcinoma were identified retrospectively. Following microdissection, when necessary, concordance of EGFR and KRAS molecular testing results between FNA CBs and histology samples was evaluated. Results: EGFR and/or KRAS testing was performed on samples obtained from 26 patients. Concordant results were obtained for all EGFR (22/22) and KRAS (17/17) mutation analyses performed. Conclusions: Identification of mutations in lung adenocarcinomas affects clinical decision-making, and it is important that results from small samples be accurate. This study demonstrates that molecular testing on cytology CBs is as sensitive and specific as that on histology.",
keywords = "Cell blocks, cytopathology, endobronchial ultrasound-guided, epidermal growth factor receptor, fine needle aspiration, Kirsten rat sarcoma, lung adenocarcinoma, molecular testing",
author = "Jonas Heymann and William Bulman and Roger Maxfield and Charles Powell and Balazs Halmos and Joshua Sonett and Nike Beaubier and John Crapanzano and Mahesh Mansukhani and Anjali Saqi",
year = "2014",
month = "1",
day = "1",
doi = "10.4103/1742-6413.132989",
language = "English (US)",
volume = "11",
journal = "CytoJournal",
issn = "0974-5963",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "1",

}

TY - JOUR

T1 - Molecular testing guidelines for lung adenocarcinoma

T2 - Utility of cell blocks and concordance between fine-needle aspiration cytology and histology samples

AU - Heymann, Jonas

AU - Bulman, William

AU - Maxfield, Roger

AU - Powell, Charles

AU - Halmos, Balazs

AU - Sonett, Joshua

AU - Beaubier, Nike

AU - Crapanzano, John

AU - Mansukhani, Mahesh

AU - Saqi, Anjali

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: Lung cancer is a leading cause of mortality, and patients often present at a late stage. More recently, advances in screening, diagnosing, and treating lung cancer have been made. For instance, greater numbers of minimally invasive procedures are being performed, and identification of lung adenocarcinoma driver mutations has led to the implementation of targeted therapies. Advances in molecular techniques enable use of scant tissue, including cytology specimens. In addition, per recently published consensus guidelines, cytology-derived cell blocks (CBs) are preferred over direct smears. Yet, limited comparison of molecular testing of fine-needle aspiration (FNA) CBs and corresponding histology specimens has been performed. This study aimed to establish concordance of epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (KRAS) virus homolog testing between FNA CBs and histology samples from the same patients. Materials and Methods: Patients for whom molecular testing for EGFR or KRAS was performed on both FNA CBs and histology samples containing lung adenocarcinoma were identified retrospectively. Following microdissection, when necessary, concordance of EGFR and KRAS molecular testing results between FNA CBs and histology samples was evaluated. Results: EGFR and/or KRAS testing was performed on samples obtained from 26 patients. Concordant results were obtained for all EGFR (22/22) and KRAS (17/17) mutation analyses performed. Conclusions: Identification of mutations in lung adenocarcinomas affects clinical decision-making, and it is important that results from small samples be accurate. This study demonstrates that molecular testing on cytology CBs is as sensitive and specific as that on histology.

AB - Background: Lung cancer is a leading cause of mortality, and patients often present at a late stage. More recently, advances in screening, diagnosing, and treating lung cancer have been made. For instance, greater numbers of minimally invasive procedures are being performed, and identification of lung adenocarcinoma driver mutations has led to the implementation of targeted therapies. Advances in molecular techniques enable use of scant tissue, including cytology specimens. In addition, per recently published consensus guidelines, cytology-derived cell blocks (CBs) are preferred over direct smears. Yet, limited comparison of molecular testing of fine-needle aspiration (FNA) CBs and corresponding histology specimens has been performed. This study aimed to establish concordance of epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (KRAS) virus homolog testing between FNA CBs and histology samples from the same patients. Materials and Methods: Patients for whom molecular testing for EGFR or KRAS was performed on both FNA CBs and histology samples containing lung adenocarcinoma were identified retrospectively. Following microdissection, when necessary, concordance of EGFR and KRAS molecular testing results between FNA CBs and histology samples was evaluated. Results: EGFR and/or KRAS testing was performed on samples obtained from 26 patients. Concordant results were obtained for all EGFR (22/22) and KRAS (17/17) mutation analyses performed. Conclusions: Identification of mutations in lung adenocarcinomas affects clinical decision-making, and it is important that results from small samples be accurate. This study demonstrates that molecular testing on cytology CBs is as sensitive and specific as that on histology.

KW - Cell blocks

KW - cytopathology

KW - endobronchial ultrasound-guided

KW - epidermal growth factor receptor

KW - fine needle aspiration

KW - Kirsten rat sarcoma

KW - lung adenocarcinoma

KW - molecular testing

UR - http://www.scopus.com/inward/record.url?scp=84906997968&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84906997968&partnerID=8YFLogxK

U2 - 10.4103/1742-6413.132989

DO - 10.4103/1742-6413.132989

M3 - Article

VL - 11

JO - CytoJournal

JF - CytoJournal

SN - 0974-5963

IS - 1

M1 - 12

ER -