Review article: A reevaluation of the clinical significance of histological subtyping of non-small-cell lung carcinoma: Diagnostic algorithms in the era of personalized treatments

Giulio Rossi, Giuseppe Pelosi, Paolo Graziano, Mattia Barbareschi, Mauro Papotti

Research output: Contribution to journalArticle

Abstract

The classification of lung cancer has always been primarily based on the morphologic assessment of routinely stained histological sections, but this approach may be difficult or even unfeasible in cytological preparations or small biopsies. Moreover, the simplistic dichotomization between small-cell carcinoma and non-small cell carcinoma (NSCLC) should be overcome, as new drugs have been discovered that are effective in specific subtypes of lung cancer. A more accurate characterization of NSCLC, however, may be hard in carcinomas lacking clear-cut signs of differentiation. The incorporation into the diagnostic algorithm of poorly differentiated carcinomas of an immunohistochemical panel including markers of squamous (high-molecular-weight cytokeratins, p63) and glandular (TTF-1, cytokeratin 7) cell differentiation seems the most promising approach. The evaluation of lung cancer for gene mutations, gene amplification, tumor-related angiogenesis, expression levels of DNA repair genes and genomic or proteomic profiles represents an exciting challenge for the pathologist in the near future.

Original languageEnglish
Pages (from-to)206-218
Number of pages13
JournalInternational Journal of Surgical Pathology
Volume17
Issue number3
DOIs
Publication statusPublished - Jun 2009

Keywords

  • Amplification
  • Antibody panel
  • DNA repair
  • Gene
  • Immunohistochemistry
  • Morphology
  • Mutation
  • Non-small cell lung carcinoma
  • Small cell lung carcinoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

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