[Non-small cell lung cancer. Subtyping and predictive molecular marker investigations in cytology].
The diagnosis and treatment of non-small cell lung cancer (NSCLC) have been revolutionized over the last few years. Requirements for cytopathologists in lung cancer diagnosis have therefore changed. The general diagnostic category of NSLC is no longer sufficient. In addition cytological specimens need to be evaluated for adequacy regarding predictive marker analyses. Accurate NSCLC subtyping with a distinction of adenocarcinoma from squamous cell carcinoma is crucial for treatment decisions as the subtype will decide on the chemotherapy regimen and the choice of predictive marker analyses for targeted treatment. In the majority of cases, the subtype can be diagnosed by morphology alone. Cytology is equally well suited as biopsy specimens for the assessment of molecular predictive markers. The best results are achieved when both cytology and biopsy specimens are compared to choose the most appropriate specimen for morphological subtyping and molecular testing. In this paper, we discuss special issues of NSCLC subtyping and currently recommended predictive molecular marker analyses.
Institut für Pathologie, Universitätsspital Basel, Schönbeinstr. 40, 4031, Basel, Schweiz. ssavic@uhbs.ch
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Bubendorf
D000230:Adenocarcinoma / Q000145:classification / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D000465:Algorithms; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D002289:Carcinoma, Non-Small-Cell Lung / Q000145:classification / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000145:classification / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D003585:Cell Biology; D004252:DNA Mutational Analysis; D066246:ErbB Receptors / Q000235:genetics; D005819:Genetic Markers / Q000235:genetics*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000145:classification / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D009367:Neoplasm Staging; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D011237:Predictive Value of Tests; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D016896:Treatment Outcome; D018631:ras Proteins / Q000235:genetics
D000970:Antineoplastic Agents; C522504:EML4-ALK fusion protein, human; D005819:Genetic Markers; C117307:KRAS protein, human; D015514:Oncogene Proteins, Fusion; D011518:Proto-Oncogene Proteins; C512478:EGFR protein, human; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins