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Hendry S, Byrne DJ, Christie M, Steinfort DP, Irving LB, Wagner CA, Ellwood T, Cooper WA, Fox SB. Adequate tumour cellularity is essential for accurate PD-L1 immunohistochemistry assessment on cytology cell-block specimens. Cytopathology 2020; 31:90-95. [PMID: 31808243 DOI: 10.1111/cyt.12795] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 11/15/2019] [Accepted: 12/02/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVES PD-L1 immunohistochemistry (IHC) is an essential predictive biomarker for patients with non-small cell lung cancer (NSCLC), required to inform treatment decisions regarding anti-PD-1 immune checkpoint inhibitor therapy. This study aims to investigate the concordance between PD-L1 IHC assessed on NSCLC cytology and histology specimens and to determine the impactce of tumour cellularity. METHODS Matched cytology and histology NSCLC specimens were retrieved from the archives of the Royal Melbourne Hospital and the Royal Prince Alfred Hospital. PD-L1 IHC was performed concurrently on both specimens at the Peter MacCallum Cancer Centre using the SP263 assay kit on the Ventana Benchmark Ultra staining platform and scored by two experienced pathologists. RESULTS Overall agreement between matched cytology and histology specimens was good (intraclass correlation coefficient = 0.653, n = 58); however, markedly increased when the analysis was limited to cell-blocks with >100 tumour cells (intraclass correlation coefficient = 0.957, n = 29). Specificity at both 1% and 50% cut-offs was high regardless of cellularity; however, sensitivity decreased in samples with <100 tumour cells. CONCLUSIONS PD-L1 IHC on cytology cell-block specimens in NSCLC is an acceptable alternative to histological specimens, provided adequate tumour cells are present. Clinicians and pathologists should be mindful of the risk of false negative PD-L1 IHC in samples with low tumour cellularity, to avoid excluding patients from potentially beneficial treatment.
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Affiliation(s)
- Shona Hendry
- Department of Pathology at Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Department of Pathology at St Vincent's Hospital, Melbourne, VIC, Australia
| | - David J Byrne
- Department of Pathology at Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Michael Christie
- Department of Pathology at Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Daniel P Steinfort
- Department of Respiratory & Sleep Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia.,Department of Medicine (RMH), University of Melbourne, Melbourne, VIC, Australia
| | - Louis B Irving
- Department of Respiratory & Sleep Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Carrie-Anne Wagner
- Department of Respiratory & Sleep Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Timothy Ellwood
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Wendy A Cooper
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Stephen B Fox
- Department of Pathology at Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Department of Medical Oncology at the University of Melbourne, Melbourne, VIC, Australia
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Ellwood T, Cooper W. Comparative study of pd-l1 expression in paired fine-needle aspiration and core biopsy specimens of non-small cell lung cancer. Pathology 2019. [DOI: 10.1016/j.pathol.2018.12.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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