The Johns Hopkins Medical Institutions, USA
Title: Biomarkers in the accurate classification of Non-Small Cell Lung Carcinomas (NSCLC) for targeted therapies: An evidence-based practice
Biography: Qing Kay Li
The current recommendations of IASLC (International Association for the Study of Lung Cancer) and the WHO classification (2015 edition) emphasize the use of minimal tumor tissue for morphological diagnosis and for immunohistochemical (IHC) stains. Accurate classification of NSCLC into adenocarcinoma (ADC) and/or squamous cell carcinoma (SqCC) plays a crucial role in molecular targeted therapies and clinical management of lung cancer patients. The morphological heterogeneity and updated classification criteria of lung cancer present diagnostic challenges in using small biopsy specimens. The distinction between ADC and SqCC may be difficult in small fine needle aspiration (FNA) biopsy specimens. Here, we will discuss the sensitivity and specificity of commonly used IHC biomarkers, including TTF-1, Napsin A, CK7, P63, P40 and CK5/6 in the classification of NSCLC. Furthermore, the combination of several individual IHC markers into a novel triple biomarker is increasingly used in daily practice. We will also discuss our data of this novel triple biomarker in the sub-classification of NSCLC, including its limitation and diagnostic pitfall. The optimal goal of current practice is preservation of tumor tissue for molecular analysis, and to provide the guidance for molecular targeted therapy.