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Is the sum of positive neuroendocrine immunohistochemical stains useful for diagnosis of large cell neuroendocrine carcinoma (LCNEC) on biopsy specimens?
- Source :
- Histopathology, Histopathology, 74(4), 555-566. Wiley, Histopathology, 74(4), 555-566. Wiley-Blackwell Publishing Ltd
- Publication Year :
- 2019
- Publisher :
- John Wiley and Sons Inc., 2019.
-
Abstract
- Aims Pulmonary large cell neuroendocrine carcinoma (LCNEC) is underdiagnosed on biopsy specimens. We evaluated if routine neuroendocrine immunohistochemical (IHC) stains are helpful in the diagnosis of LCNEC on biopsy specimens. Methods and results Using the Dutch pathology registry (PALGA), surgically resected LCNEC with matching pre-operative biopsy specimens were identified and haematoxylin and IHC slides (CD56, chromogranin-A, synaptophysin) requested. Subsequently, three pathologists assigned (1) the presence or absence of the WHO 2015 criteria and (2) cumulative size of all (biopsy) specimens. For validation, a tissue microarray (TMA) of non-small-cell lung cancer (NSCLC) (n = 77) and LCNEC (n = 19) was used. LCNEC was confirmed on the resection specimens in 32 of 48 re-reviewed cases. In 47% (n = 15 of 32) LCNEC was also confirmed in the paired biopsy specimens. Neuroendocrine morphology was absent in 53% (n = 17 of 32) of paired biopsy specimens, more often when smaller amounts of tissue were available for evaluation [29% = 5 mm (n = 18) P = 0.04]. Combined with current WHO criteria, positive staining for greater than or equal to two of three neuroendocrine IHC markers increased the sensitivity for LCNEC from 47% to 93% on paired biopsy specimens, and further validated using an independent TMA of LCNEC and NSCLC with sensitivity and specificity of 80% and 99%, respectively. Conclusions LCNEC is difficult to diagnose because neuroendocrine morphology is frequently absent in biopsy specimens. In NSCLC devoid of obvious morphological squamous or adenocarcinoma features, positive staining in greater than or equal to two of three neuroendocrine IHC stains supports the diagnosis of LCNEC.
- Subjects :
- 0301 basic medicine
Male
Pathology
PROGNOSIS
neuroendocrine (MESH)
Lung Neoplasms
FEATURES
Biopsy
carcinoma
0302 clinical medicine
diagnosis (MESH)
WHO classification
Tissue microarray
medicine.diagnostic_test
biology
General Medicine
CHEMOTHERAPY
Middle Aged
PATHOLOGICAL DIAGNOSIS
TUMORS
Immunohistochemistry
DIFFERENTIATION
030220 oncology & carcinogenesis
Adenocarcinoma
Original Article
Female
biopsy (MESH)
EXPRESSION
medicine.medical_specialty
Histology
SOCIETY
CLASSIFICATION
Pathology and Forensic Medicine
LCNEC
03 medical and health sciences
lung neoplasms (MESH)
LUNG-CANCER
medicine
Carcinoma
Biomarkers, Tumor
sensitivity and specificity (MESH)
Humans
Lung cancer
Aged
Retrospective Studies
Staining and Labeling
business.industry
Original Articles
Large cell neuroendocrine carcinoma of the lung
medicine.disease
Carcinoma, Neuroendocrine
030104 developmental biology
Synaptophysin
biology.protein
Carcinoma, Large Cell
business
Subjects
Details
- Language :
- English
- ISSN :
- 13652559 and 03090167
- Volume :
- 74
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Histopathology
- Accession number :
- edsair.doi.dedup.....b5cfb3e01611d74720f03b1293957990