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H. Takei

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    P1.02 - Biology/Pathology (ID 614)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Biology/Pathology
    • Presentations: 1
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      P1.02-033 - Differentiating of Cytomorphological Characteristics in Non-Small Cell Lung Cancer Predicts Value of Radiologic Features (ID 9355)

      09:30 - 16:00  |  Author(s): H. Takei

      • Abstract
      • Slides

      In the 2011 IASLC/ATS/ERS classification, guidelines recommend that the major adenocarcinoma (ADC) subtypes should be classified according to the predominant histologic pattern. In published papers, the ADC classification has significant prognostic and predictive value regarding death or recurrence has been reported. The purpose of this study was to retrospectively evaluate characteristic differences between cytomorphological findings among histological subtypes in the preoperative bronchoscopic materials and radiologic features on high-resolution computed tomography (HRCT) and [(18)F]-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) /CT examinations in our database.

      Forty-four consecutive lung cancer patients with peripheral lung nodules diagnosed by bronchoscopic biopsies underwent surgery in our hospital from April 2011 to May 2016. The cyotologic material obtained by brushing bronchoscopically was placed onto a glass slide, immediately fixed in 95% ethanol, and stained with Papanicolaou stain. The cytomorphological studies were retrospectively performed separately by two experienced cytotechnicians. Clinicopathological data with preoperative radiologic features on HRCT and 18F-FDG PET/CT in the patients was utilized for comparing to cytomorphological analyses.

      Out of the forty-four patients with lung cancer, by excluding one typical carcinoid and four not otherwise specified (NOS), thirty-nine specimens in the patients consisted of ADC (n=32) and squamous cell carcinoma (SQCC, n=7) were analyzed. Thirty-two ADC were subclassified cytomorphologically into acinar (n=22), solid (n=8), papillary (n=1) and lepidic (n=1). The subtypes of ADC except for eight solids were categorized as nonsolid of ADC on comparisons of analyzed data. Specimens classified as solid pattern of ADC had a predominant 3D clusters (8 of 8 specimens, 100%) and conspicuous nucleoli (7 of 8 specimens, 87.5%) than nonsolid patterns of ADC. There were statistically significant differences between the nonsolid and the solid patterns about the two features (P=0.0011 and 0.0007, respectively). C/T ratio (a diameter of consolidation divided by a diameter tumor size) of the nonsolid pattern (0.9±0.1) was significantly lower than that for the solid pattern and the SQCC (1.0±0.0) (p=0.01). Maximum standardized uptake value (SUVmax) of the SQCC at 60 and 120 minutes (12.3±4.0 and 16.9±7.3) was significantly higher than that for the nonsolid pattern of ADC (7.0±3.6 and 9.0±4.6; P=0.003 and 0.004, respectively). Figure 1

      Preoperative cytomorphological subtyping might predict value of radiologic features on CT and PET examinations, therefore their features also could provide information about a degree of pathological invasiveness or biological malignancy of tumor with some decisions for treatments.

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