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Takaaki Ito
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EP1.12 - Small Cell Lung Cancer/NET (ID 202)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Small Cell Lung Cancer/NET
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.12-03 - The Significance of INSM1 Expression in Small Cell Lung Cancer (Now Available) (ID 2132)
08:00 - 18:00 | Author(s): Takaaki Ito
- Abstract
Background
We previously demonstrated that INSM1 expressed in NE tumors (NETs) exclusively and INSM1 is a highly sensitive and specific immunohistochemical (IHC) marker in NETs, such as small cell lung cancer (SCLC). In the present study, we investigated 1) diagnostic performance of INSM1 in the diagnosis of SCLC in various types of samples 2) the association of INSM1 with clinical course.
Method
We evaluated INSM1 as an IHC marker in 384 formalin-fixed paraffin-embedded lung cancer samples (291 surgically resected samples (90 SCLCs and 201 NSCLCs) and 55 CT-guided biopsy samples (25 SCLCs and 30 NSCLCs)), in 50 cytology samples (25 SCLC metastatic lymph nodes and 25 NSCLCs) obtained by endobronchial ultrasound-guided transbronchial needle aspiration. The mRNA expression levels of INSM1 was examined using qRT-PCR in 37 SCLCs and 40 NSCLCs. We evaluated the association of INSM1 expression (IHC and qRT-PCR data) with clinical course.
Result
INSM1 was expressed in 94% of formalin-fixed paraffin-embedded SCLC samples (109/115) and in 92% of cytology SCLC samples (23/25). Whereas, 4 out of 231 formalin-fixed paraffin-embedded NSCLC cases (1.7%) had weak expression of INSM1 and none of the cytology NSCLC samples were positive. The mRNA level of INSM1 was significantly higher in SCLCs including in two cases who were INSM1 negative with IHC. No association between IHC positivity and mRNA expression level of INSM1 with evaluated clinical features including overall survival was observed.
Conclusion
Our study suggests INSM1 is a reliable IHC marker for SCLC in various types of clinical samples. There was no association between INSM1 and clinical courses in the present study.
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P2.09 - Pathology (ID 174)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Pathology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.09-10 - INSM1 Is a Good Marker for Diagnosis of Small Cell Lung Carcinoma Even When Neuroendocrine Marker Negative (Now Available) (ID 1104)
10:15 - 18:15 | Author(s): Takaaki Ito
- Abstract
Background
To diagnose small cell lung carcinoma (SCLC), neuroendocrine (NE) phenotype markers such as chromogranin A, synaptophysin and CD56 are helpful. However, because they are dispensable, SCLCs occur without neuroendocrine phenotypes. Insulinoma-associated protein 1 (INSM1) is a transcription factor for neuroendocrine differentiation and has emerged as a single practical marker for SCLC.
Method
Using the surgical samples of 141 NE tumors (78 SCLCs, 44 large cell neuroendocrine carcinomas (LCNECs), and 19 carcinoids), and 246 non-NE carcinomas, we examined the immunohistochemical expression and prognostic relevance of INSM1 in association with NE phenotype markers in each histologic type. We evaluated its sensitivity and specificity for SCLC diagnosis, as well as its usefulness to diagnose SCLC without NE marker expression and to estimate the prognosis of the subgroups of SCLC stratified by the expression levels of the NE markers. Those of 13 lung cancer cell lines (9 SCLCs and 4 ADCs) were also evaluated.
Result
INSM1 was expressed in SCLCs (92%, 72/78), LCNECs (68%, 30/44), and carcinoids (95%, 18/19). Additionally, among SCLCs with no expression of NE phenotype markers (n=12), 9 (75%) were positive for INSM1. These data suggest the superiority of INSM1 to the phenotype markers. SCLC with low INSM1 expression (n=28) had a significantly better prognosis (P=0.040) than the high-INSM1 group (n=50). Only 7% of adenocarcinomas (9/134) and 4% of squamous cell carcinomas (4/112) were positive for INSM1. In cell lines, most SCLCs were positive for INSM1 (7/9), whereas all ADCs were negative (0/4).
Conclusion
Our study revealed that INSM1 is highly sensitive to detect SCLC, is positive in most phenotype marker-negative SCLCs and can estimate prognosis. INSM1 will be a promising marker for SCLC.
