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Takashi Inoue
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P38 - Pathology - Pathology/Staging (ID 108)
- Event: WCLC 2020
- Type: Posters
- Track: Pathology, Molecular Pathology and Diagnostic Biomarkers
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P38.04 - 3D Analysis of Spread Through Air Spaces in Squamous Cell Carcinoma and Carcinoid Tumor Using Whole Block Imaging by Micro CT (ID 810)
00:00 - 00:00 | Presenting Author(s): Takashi Inoue
- Abstract
Introduction
Spread through air spaces (STAS) is defined as the spread of lung cancer cells into air spaces within the lung parenchyma adjacent to the main tumor. In squamous cell carcinoma (SCC) and neuroendocrine tumor (NET) cases, STAS are usually identified as solid nest structures in the air space beyond the edge of the main tumor. Many reports show that STAS is an independent prognostic factor for recurrence.
Micro-computed tomography (micro-CT) is a non-invasive method which allows three-dimensional (3D) morphometric analysis of tissue in formalin-fixed paraffin-embedded (FFPE) tissue blocks without any sectioning or loss of sample.
The aim of this study is to analyze the 3D structure of STAS in SCC and carcinoid tumor by whole block imaging (WBI) of FFPE tissue blocks using micro-CT. The FFPE blocks were then sectioned, stained with hematoxylin and eosin (H&E), and scanned to create whole slide images for comparison.
Methods
FFPE tissue blocks from five SCC cases, one atypical carcinoid (AC) tumor case, and four typical carcinoid (TC) tumor cases with STAS were scanned using a custom-built micro-CT scanner (Nikon Metrology), and digitally re-constructed for visualization and analysis using a digital image system. All H&E slides were scanned using a whole slide imaging scanner with a calibration of 0.5 μm/pixel. We investigated the correlation between micro-CT images and whole slide images and investigated the 3D analysis of STAS in micro-CT images.
Results
Micro-CT of FFPE blocks was used to image the structure of lung tumors (both SCC and NET) and normal lung tissue. We could detect STAS in micro-CT images (Figures 1-1, 2-1). STAS in SCC were solid nest structures beyond the edge of the main tumor and were connected directly to the main tumor according to 3D analysis using Micro CT images (Figure1-2). STAS in carcinoid tumors (both AC and TC) were also solid nest structures beyond the edge of the main tumor, but they were not connected to the main tumor directly, instead they were attached to the alveolar wall according to 3D analysis using Micro CT images (Figure2-2).
Conclusion
WBI using micro-CT allows for the identification of STAS in SCC, AC, and TC in FFPE blocks in a non-invasive and non-destructive manner. Our study suggests that STAS in SCC are directly connected to the main tumor (like tumor islands), and STAS in AC and TC are not directly connected to the main tumor, but are attached to the alveolar wall.
