Expression of programmed cell death ligand 1 in non-small cell lung cancer: Comparison between cytologic smears, core biopsies, and whole sections using the SP263 Assay

Enrico Munari, Giuseppe Zamboni, Giorgia Sighele, Marcella Marconi, Marco Sommaggio, Gianluigi Lunardi, Giulio Rossi, Alberto Cavazza, Francesca Moretta, Eliana Gilioli, Anna Caliò, George J Netto, Mohammad O Hoque, Guido Martignoni, Matteo Brunelli, Paola Vacca, Lorenzo Moretta, Giuseppe Bogina

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Evaluation of programmed cell death ligand 1 (PD-L1) expression can be made on both resection specimens and diagnostic biopsies; however, more than 30% of patients with advanced non-small cell lung cancer (NSCLC) do not have adequate histologic material to perform PD-L1 assays and require additional biopsies. In addition, in our practice, more than 16% of cases have cytological smears as the only available material. Our aim was to validate the PD-L1 immunocytochemistry assay on cytological smears and compare its accuracy with the results obtained from tissue cores and whole tumor sections using the clinically relevant cutoff of 50%.

METHOD: We compared the PD-L1 staining results of cytological smears to those from tissue cores or whole sections in 50 and 53 NSCLC cases, respectively, using the SP263 assay after scanning hematoxylin and eosin slides.

RESULTS: We found an overall agreement of 90.6% between cytological smears and whole sections; specifically, we found absolute concordance between smears with PD-L1 expressed in <10% and ≥50% of cells and whole sections with PD-L1 expressed in <50% and ≥50% of cells, respectively. In addition, slightly lower diagnostic accuracy was found for the cytological smears in comparison with the tissue cores, but the difference was not statistically significant. We found excellent intraobserver and good interobserver agreement in the evaluation of PD-L1 on smears.

CONCLUSION: Immunocytochemistry on cytological smears is a reliable method for determination of PD-L1 at the 50% cutoff when positive cells are <10% or ≥50%; for cases showing PD-L1 expression in 10% to 49% of cells, additional tissue sampling may be necessary.

Original languageEnglish
Number of pages10
JournalCancer cytopathology
DOIs
Publication statusE-pub ahead of print - Nov 30 2018

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Non-Small Cell Lung Carcinoma
Cell Death
Ligands
Biopsy
Immunohistochemistry
Hematoxylin
Eosine Yellowish-(YS)
Staining and Labeling

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Expression of programmed cell death ligand 1 in non-small cell lung cancer : Comparison between cytologic smears, core biopsies, and whole sections using the SP263 Assay. / Munari, Enrico; Zamboni, Giuseppe; Sighele, Giorgia; Marconi, Marcella; Sommaggio, Marco; Lunardi, Gianluigi; Rossi, Giulio; Cavazza, Alberto; Moretta, Francesca; Gilioli, Eliana; Caliò, Anna; Netto, George J; Hoque, Mohammad O; Martignoni, Guido; Brunelli, Matteo; Vacca, Paola; Moretta, Lorenzo; Bogina, Giuseppe.

In: Cancer cytopathology, 30.11.2018.

Research output: Contribution to journalArticle

Munari, E, Zamboni, G, Sighele, G, Marconi, M, Sommaggio, M, Lunardi, G, Rossi, G, Cavazza, A, Moretta, F, Gilioli, E, Caliò, A, Netto, GJ, Hoque, MO, Martignoni, G, Brunelli, M, Vacca, P, Moretta, L & Bogina, G 2018, 'Expression of programmed cell death ligand 1 in non-small cell lung cancer: Comparison between cytologic smears, core biopsies, and whole sections using the SP263 Assay', Cancer cytopathology. https://doi.org/10.1002/cncy.22083
Munari, Enrico ; Zamboni, Giuseppe ; Sighele, Giorgia ; Marconi, Marcella ; Sommaggio, Marco ; Lunardi, Gianluigi ; Rossi, Giulio ; Cavazza, Alberto ; Moretta, Francesca ; Gilioli, Eliana ; Caliò, Anna ; Netto, George J ; Hoque, Mohammad O ; Martignoni, Guido ; Brunelli, Matteo ; Vacca, Paola ; Moretta, Lorenzo ; Bogina, Giuseppe. / Expression of programmed cell death ligand 1 in non-small cell lung cancer : Comparison between cytologic smears, core biopsies, and whole sections using the SP263 Assay. In: Cancer cytopathology. 2018.
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title = "Expression of programmed cell death ligand 1 in non-small cell lung cancer: Comparison between cytologic smears, core biopsies, and whole sections using the SP263 Assay",
abstract = "BACKGROUND: Evaluation of programmed cell death ligand 1 (PD-L1) expression can be made on both resection specimens and diagnostic biopsies; however, more than 30{\%} of patients with advanced non-small cell lung cancer (NSCLC) do not have adequate histologic material to perform PD-L1 assays and require additional biopsies. In addition, in our practice, more than 16{\%} of cases have cytological smears as the only available material. Our aim was to validate the PD-L1 immunocytochemistry assay on cytological smears and compare its accuracy with the results obtained from tissue cores and whole tumor sections using the clinically relevant cutoff of 50{\%}.METHOD: We compared the PD-L1 staining results of cytological smears to those from tissue cores or whole sections in 50 and 53 NSCLC cases, respectively, using the SP263 assay after scanning hematoxylin and eosin slides.RESULTS: We found an overall agreement of 90.6{\%} between cytological smears and whole sections; specifically, we found absolute concordance between smears with PD-L1 expressed in <10{\%} and ≥50{\%} of cells and whole sections with PD-L1 expressed in <50{\%} and ≥50{\%} of cells, respectively. In addition, slightly lower diagnostic accuracy was found for the cytological smears in comparison with the tissue cores, but the difference was not statistically significant. We found excellent intraobserver and good interobserver agreement in the evaluation of PD-L1 on smears.CONCLUSION: Immunocytochemistry on cytological smears is a reliable method for determination of PD-L1 at the 50{\%} cutoff when positive cells are <10{\%} or ≥50{\%}; for cases showing PD-L1 expression in 10{\%} to 49{\%} of cells, additional tissue sampling may be necessary.",
author = "Enrico Munari and Giuseppe Zamboni and Giorgia Sighele and Marcella Marconi and Marco Sommaggio and Gianluigi Lunardi and Giulio Rossi and Alberto Cavazza and Francesca Moretta and Eliana Gilioli and Anna Cali{\`o} and Netto, {George J} and Hoque, {Mohammad O} and Guido Martignoni and Matteo Brunelli and Paola Vacca and Lorenzo Moretta and Giuseppe Bogina",
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T1 - Expression of programmed cell death ligand 1 in non-small cell lung cancer

T2 - Comparison between cytologic smears, core biopsies, and whole sections using the SP263 Assay

AU - Munari, Enrico

AU - Zamboni, Giuseppe

AU - Sighele, Giorgia

AU - Marconi, Marcella

AU - Sommaggio, Marco

AU - Lunardi, Gianluigi

AU - Rossi, Giulio

AU - Cavazza, Alberto

AU - Moretta, Francesca

AU - Gilioli, Eliana

AU - Caliò, Anna

AU - Netto, George J

AU - Hoque, Mohammad O

AU - Martignoni, Guido

AU - Brunelli, Matteo

AU - Vacca, Paola

AU - Moretta, Lorenzo

AU - Bogina, Giuseppe

N1 - © 2018 American Cancer Society.

PY - 2018/11/30

Y1 - 2018/11/30

N2 - BACKGROUND: Evaluation of programmed cell death ligand 1 (PD-L1) expression can be made on both resection specimens and diagnostic biopsies; however, more than 30% of patients with advanced non-small cell lung cancer (NSCLC) do not have adequate histologic material to perform PD-L1 assays and require additional biopsies. In addition, in our practice, more than 16% of cases have cytological smears as the only available material. Our aim was to validate the PD-L1 immunocytochemistry assay on cytological smears and compare its accuracy with the results obtained from tissue cores and whole tumor sections using the clinically relevant cutoff of 50%.METHOD: We compared the PD-L1 staining results of cytological smears to those from tissue cores or whole sections in 50 and 53 NSCLC cases, respectively, using the SP263 assay after scanning hematoxylin and eosin slides.RESULTS: We found an overall agreement of 90.6% between cytological smears and whole sections; specifically, we found absolute concordance between smears with PD-L1 expressed in <10% and ≥50% of cells and whole sections with PD-L1 expressed in <50% and ≥50% of cells, respectively. In addition, slightly lower diagnostic accuracy was found for the cytological smears in comparison with the tissue cores, but the difference was not statistically significant. We found excellent intraobserver and good interobserver agreement in the evaluation of PD-L1 on smears.CONCLUSION: Immunocytochemistry on cytological smears is a reliable method for determination of PD-L1 at the 50% cutoff when positive cells are <10% or ≥50%; for cases showing PD-L1 expression in 10% to 49% of cells, additional tissue sampling may be necessary.

AB - BACKGROUND: Evaluation of programmed cell death ligand 1 (PD-L1) expression can be made on both resection specimens and diagnostic biopsies; however, more than 30% of patients with advanced non-small cell lung cancer (NSCLC) do not have adequate histologic material to perform PD-L1 assays and require additional biopsies. In addition, in our practice, more than 16% of cases have cytological smears as the only available material. Our aim was to validate the PD-L1 immunocytochemistry assay on cytological smears and compare its accuracy with the results obtained from tissue cores and whole tumor sections using the clinically relevant cutoff of 50%.METHOD: We compared the PD-L1 staining results of cytological smears to those from tissue cores or whole sections in 50 and 53 NSCLC cases, respectively, using the SP263 assay after scanning hematoxylin and eosin slides.RESULTS: We found an overall agreement of 90.6% between cytological smears and whole sections; specifically, we found absolute concordance between smears with PD-L1 expressed in <10% and ≥50% of cells and whole sections with PD-L1 expressed in <50% and ≥50% of cells, respectively. In addition, slightly lower diagnostic accuracy was found for the cytological smears in comparison with the tissue cores, but the difference was not statistically significant. We found excellent intraobserver and good interobserver agreement in the evaluation of PD-L1 on smears.CONCLUSION: Immunocytochemistry on cytological smears is a reliable method for determination of PD-L1 at the 50% cutoff when positive cells are <10% or ≥50%; for cases showing PD-L1 expression in 10% to 49% of cells, additional tissue sampling may be necessary.

U2 - 10.1002/cncy.22083

DO - 10.1002/cncy.22083

M3 - Article

C2 - 30500997

JO - Cancer cytopathology

JF - Cancer cytopathology

SN - 1934-662X

ER -