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Chunyan Wu
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P1.09 - Pathology (ID 173)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.09-23 - A33 and SATB2 Immunohistochemistry for Differentiating Metastatic Colorectal Carcinoma from Pulmonary Enteric Adenocarcinoma (ID 2186)
09:45 - 18:00 | Author(s): Chunyan Wu
- Abstract
Background
Primary pulmonary enteric adenocarcinoma (PEAD) resemble morphology and immunohistochemistry with metastatic colorectal carcinoma(mCRC). it is sometimes difficult to differentiate PEAD from mCRC. Here, we evaluated the diagnostic value of A33 and SATB2 in discriminating between PEAD and mCRC.
Method
Resected 39 PEAD and 69 mCRC cases were retrospectively recruited. PEAD patients were performed colonoscopy postoperatively and were followed more than 1 year to exclude mCRC. Patients with mCRC were diagnosed by colorectal carcinoma history before or after thoracic surgery. A panel of immuohistochemistry markers were analyzed including A33, SATB2, CK7, CK20, TTF-1, Napisn A, CDX2 and villin. Tumor staining was scored for positive percentage and intensity, with a maximum possible score of 300.
Result
A33, SATB2 and CK20 showed specificity for PEAD: 94.9%, 92.3% and 88.9%, respectively; sensitivity for mCRC: 97.1%, 97.1% and 91.3%, respectively. CK7 expression was 91.4% sensitive and 90.9% specific for PEAD. A33 and SATB2 were slightly higher than CK20 for specificity in PEAD. The AUC for tumor staining of A33, SATB2 was 0.994 and 0.984, individually; In combination of them, the AUC was 1.000. The staining of TTF-1 was focal and weak in one mCRC case. No Napsin A expression was found in mCRC. The positive rate of TTF-1 and Naspin A expression in PEAD was 46.2% (18/39) and 25.6% (10/39). There was similar for CDX2 and villin expression between PEAD and mCRC.
Conclusion
Our results showed that a panel of A33 and SATB2 was potentially optimal markers for differentiating PEAD from metastatic colorectal carcinoma.
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P2.09 - Pathology (ID 174)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 2
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.09-12 - Next-Generation Sequencing of 7 Cases with Diffusely Coexpressed TTF-1 and p40 Reveals a New Molecular Entity in Resected NSCLC (ID 685)
10:15 - 18:15 | Author(s): Chunyan Wu
- Abstract
Background
Non-small cell lung cancer (NSCLC) histological and molecular subtypes played a pivotal role in management and treatment of patients. We reported unusual 7 NSCLC cases with diffuse coexpression of TTF-1 and p40 in surgical NSCLC specimens. The clinicopathological features and molecular profile of these cases were investigated in this study.
Method
NSCLC tumors and paired normal lung tissues were performed targeted next-generation sequencing of 425 cancer genes related to treatment, genetic risks and tumorigenesis. Comprehensive immunohistochemistry and clinical information were analyzed. Genomic data was compared with TCGA database of different lung cancer subtypes.
Result
In the 7 tumors, the most frequent genomic alterations were MCL1 amplification (confirmed by FISH) and TP53 mutations (57.1%, 4/7), KEAP1 and NOTCH2 mutations (42.9%, 3/7) and MYC amplification (42.9%, 3/7), KRAS and CDKN2A mutations (28.6%, 2/7), and EGFR mutation (14.3%, 1/7). 4 cases with MCL1 amplification were frequently along with NOTCH2 mutations (3 cases) and MYC amplification (3 cases), KRAS (1 case) and EGFR mutation (1 case). Two or three genes amplification co-existed in 4 cases. KRAS mutation was detected to be mutually exclusive from both EGFR and TP53 mutation. 5 cases with tumor mutation burden were more than 10/MB. There was no microsatellite instability found in 7 cases. All tumors were centrally located, with no morphological squamous and glandular differentiation. Diffuse and strong nuclear immunopositivity for TTF-1 (clone 8G7G3/1) and p40 expressed on the same tumor cells and were confirmed by double immunofluorescence. Napsin A was negative in all cases and CK5/6 was positive for 5 cases. 5 of 6 male patients were non-smokers. One was female with no smoking history.
Conclusion
Our results illustrated that poorly differentiated NSCLC with diffuse co-expression of TTF-1 and p40 showed an unique molecular subtype compared with other lung cancer subtypes. Therapies combined with MCL1 inhibitor may be eligible for these MCL1-amplification entities.
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P2.09-31 - High Concordance of PD-L1 Antibody Between Clone 22C3 and Clone E1L3N in Non-Small Cell Lung Cancer Biopsy Samples (ID 2058)
10:15 - 18:15 | Presenting Author(s): Chunyan Wu
- Abstract
Background
PD-L1 22C3 pharmDx was approved as a companion diagnostics for predicting response to pembrolizumab of advanced non-small cell lung cancer (NSCLC) patients. However, the laboratory developed tests (LDTs) for PD-L1 immunohistochemistry were widely available and urgently be standardized in clinical routine practice. We compared the concordance between PD-L1 antibody clone E1L3N and clone 22C3 expression on the DaKo AutostainerLink48 platform in NSCLC biopsy samples.
Method
171 non-small cell lung cancer (NSCLC) biopsy samples were recruited in this study, Serial sections of FFPE blocks were used for IHC staining. The staining protocol was performed according to the standard of PD-L1 IHC 22C3 pharmDx package.
Result
PD-L1 clone E1L3N and 22C3 distributed a similar pattern in NSCLC biopsy samples. The two assays scoring of E1L3N and 22C3 were highly concordant (lower Kappa value was 0.868 for two cutoff). There was very strong reliability among two pathologists in evaluating PD-L1 scoring with two assays (the lowest PPA was 88.9% for two cutoff). The PPA range was 85.7%-96.3% for all samples. In the Bland-Altman analysis, the mean difference in percentage of tumor cells positively stained for PD-L1 between the paired assay findings was 1.36% for all samples, and 0.57%, -0.66% between the two pathologists for 22C3 and E1L3N assay, respectively.
Conclusion
The results indicated that clone E1L3N assay has a high concordance with 22C3. PD-L1 clone E1L3N assay is reliable and cost-effective, which could be used as a primary screening agent for PD-L1 IHC staining in the pathological laboratory.
