A comparison of diagnostic panels in the immunohistochemical analysis of lung cancer

Abstract

Purpose: Classi fi cation of non-small cell lung carcinoma (NSCLC), as adenocarcinoma or squamous cell carcinoma, is important both in the diagnosis and treatment of lung cancer. Use of appropriate markers for this identi fi cation is crucial in order to conserve patient tissue for further molecular testing that could guide treatment decisions and have prognostic implications. Patients and methods: We constructed tissue microarrays from archival resections of 200 NSCLC that were previously subtyped based on morphology and immunohistochemistry (IHC) in some cases. We performed IHC with three TTF-1 clones (SP141, SPT24 and 8G7G3/1), Napsin A, p40, p63 and CK5/6 and panels of four or two markers that best help identify adenocarcinoma and squamous cell carcinoma were ascertained. Results: Our results showed that the best four-marker panel utilized TTF-1 (clone SP141), Napsin A, p63 and CK5/6 with a sensitivity of 98.3% and high speci fi city of 91.7%. The best two-marker panel was TTF-1 (clone SP141) and p63 with 96.5% sensitivity and 85.71% speci fi city. Conclusion: As there are variations in the performance of different clones of TTF-1 IHC antibodies, the clone chosen can increase the diagnostic value in differentiating adenocarcinoma from squamous cell carcinoma. In the panels analyzed, the survival of cases concordant with the diagnosis had longer survival compared to those that were discordant. The difference was however not statistically signi fi cant ( p >0.05). a on panels of antibodies that work in lung carcinomas. We have collected tissue from patients who were previously diagnosed and we performed immunohistochemistry with panels of antibodies. Our results show that the best four marker panel utilized the antibodies TTF-1 (clone SP141), Napsin A, p63 and CK5/6. The best two marker panel was TTF-1 (clone SP141) and p63.