title: [Molecular pathological diagnosis in cytopathology of non-small-cell lung cancer. Standardization of specimen processing].
abstract: BACKGROUND
  Personalized medicine is becoming standard for the treatment of non-small-cell lung cancer. For example, patients with activating EGFR mutations or EML4-ALK translocations largely benefit from targeted therapies with tyrosine kinase inhibitors with better response rates and progression-free survival compared to standard chemotherapy regimens. However, the application of the respective molecular biomarker analyses requires great expertise in the handling of different cell and tissue specimens. A major challenge for reliable analyses is the usually low amount of tumor material. There are currently relatively few standardized and evidence-based guidelines for the processing and analysis of respective specimens as well as for interpretation of the test results.
  
  
  METHODS
  To establish a basis for standardized predictive cytopathological analyses, different material processing approaches and molecular pathological tests are discussed, and novel concepts and strategies are lined out in order to improve the quality and reliability of the respective diagnostic procedures.
  
  
  CONCLUSIONS
  Predictive analyses of cytological specimens can be reliably performed using smears, cytospins or cell blocks; there is no need for histological specimens. The diagnostic work-up of cytological probes should be performed as carefully as possible in order to save further tumor material for subsequent predictive analyses. With standardized and reliable procedures at hand cytopathology is an important contribution to the multidisciplinary, complex care, and treatment of lung cancer patients.
authors.affiliation: Institut für Pathologie, Universität Heidelberg, Im Neuenheimer Feld 224, Heidelberg, Germany. arne.warth@med.uni-heidelberg.de
authors.forename: A
authors.initials: A
authors.lastname: Warth
authors.forename: L
authors.initials: L
authors.lastname: Bubendorf
authors.forename: S
authors.initials: S
authors.lastname: Gütz
authors.forename: A
authors.initials: A
authors.lastname: Morresi-Hauf
authors.forename: M
authors.initials: M
authors.lastname: Hummel
authors.forename: K
authors.initials: K
authors.lastname: Junker
authors.forename: U
authors.initials: U
authors.lastname: Lehmann
authors.forename: I
authors.initials: I
authors.lastname: Petersen
authors.forename: P A
authors.initials: PA
authors.lastname: Schnabel
mesh_terms: D000077548:Anaplastic Lymphoma Kinase; D014408:Biomarkers, Tumor / Q000235:genetics; D001706:Biopsy / Q000379:methods; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D066246:ErbB Receptors / Q000235:genetics; D006801:Humans; D033183:Interdisciplinary Communication; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology*; D009154:Mutation / Q000235:genetics; D057089:Pathology, Molecular / Q000592:standards*; D057285:Precision Medicine; D011237:Predictive Value of Tests; D011379:Prognosis; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics; D014178:Translocation, Genetic
chemical_list: D014408:Biomarkers, Tumor; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; C512478:EGFR protein, human; D066246:ErbB Receptors; D020794:Receptor Protein-Tyrosine Kinases