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Formalin fixation for optimal concordance of programmed death-ligand 1 immunostaining between cytologic and histologic specimens from patients with non-small cell lung cancer.
Koomen, Bregje M; van der Starre-Gaal, Jose; Vonk, Judith M; von der Thüsen, Jan H; van der Meij, Jacqueline J C; Monkhorst, Kim; Willems, Stefan M; Timens, Wim; 't Hart, Nils A.
Afiliação
  • Koomen BM; Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • van der Starre-Gaal J; Department of Pathology, Isala Hospitals, Zwolle, the Netherlands.
  • Vonk JM; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
  • von der Thüsen JH; Department of Pathology, Erasmus Medical Center, Rotterdam, the Netherlands.
  • van der Meij JJC; Pathologie Friesland, Leeuwarden, the Netherlands.
  • Monkhorst K; Department of Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
  • Willems SM; Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Timens W; Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
  • 't Hart NA; Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Cancer Cytopathol ; 129(4): 304-317, 2021 04.
Article em En | MEDLINE | ID: mdl-33108706
BACKGROUND: Immunohistochemical staining of programmed death-ligand 1 (PD-L1) is used to determine which patients with non-small cell lung cancer (NSCLC) may benefit most from immunotherapy. Therapeutic management of many patients with NSCLC is based on cytology instead of histology. In this study, concordance of PD-L1 immunostaining between cytology cell blocks and their histologic counterparts was analyzed. Furthermore, the effect of various fixatives and fixation times on PD-L1 immunoreactivity was studied. METHODS: Paired histologic and cytologic samples from 67 patients with NSCLC were collected by performing fine-needle aspiration on pneumonectomy/lobectomy specimens. Formalin-fixed, agar-based or CytoLyt/PreservCyt-fixed Cellient cell blocks were prepared. Sections from cell blocks and tissue blocks were stained with SP263 (standardized assay) and 22C3 (laboratory-developed test) antibodies. PD-L1 scores were compared between histology and cytology. In addition, immunostaining was compared between PD-L1-expressing human cell lines fixed in various fixatives at increasing increments in fixation duration. RESULTS: Agar cell blocks and tissue blocks showed substantial agreement (κ = 0.70 and κ = 0.67, respectively), whereas fair-to-moderate agreement was found between Cellient cell blocks and histology (κ = 0.28 and κ = 0.49, respectively). Cell lines fixed in various alcohol-based fixatives showed less PD-L1 immunoreactivity compared with those fixed in formalin. In contrast to SP263, additional formalin fixation after alcohol fixation resulted in preserved staining intensity using the 22C3 laboratory-developed test and the 22C3 pharmDx assay. CONCLUSIONS: Performing PD-L1 staining on cytologic specimens fixed in alcohol-based fixatives could result in false-negative immunostaining results, whereas fixation in formalin leads to higher and more histology-concordant PD-L1 immunostaining. The deleterious effect of alcohol fixation could be reversed to some degree by postfixation in formalin.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fixação de Tecidos / Carcinoma Pulmonar de Células não Pequenas / Antígeno B7-H1 / Formaldeído / Neoplasias Pulmonares Tipo de estudo: Clinical_trials Limite: Female / Humans / Male Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fixação de Tecidos / Carcinoma Pulmonar de Células não Pequenas / Antígeno B7-H1 / Formaldeído / Neoplasias Pulmonares Tipo de estudo: Clinical_trials Limite: Female / Humans / Male Idioma: En Ano de publicação: 2021 Tipo de documento: Article