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Review
. 2018 Mar 14;10(3):72.
doi: 10.3390/cancers10030072.

Update on Immunohistochemistry for the Diagnosis of Lung Cancer

Kentaro Inamura  1
Affiliations
Review

Update on Immunohistochemistry for the Diagnosis of Lung Cancer

Kentaro Inamura. Cancers (Basel). .

Abstract

Immunohistochemistry is a widely available technique that is less challenging and can provide clinically meaningful results quickly and cost-efficiently in comparison with other techniques. In addition, immunohistochemistry allows for the evaluation of cellular localization of proteins in the context of tumor structure. In an era of precision medicine, pathologists are required to classify lung cancer into specific subtypes and assess biomarkers relevant to molecular-targeted therapies. This review summarizes the hot topics of immunohistochemistry in lung cancer, including (i) adenocarcinoma vs squamous cell carcinoma; (ii) neuroendocrine markers; (iii) ALK, ROS1, and EGFR; (iv) PD-L1 (CD274); (v) lung carcinoma vs malignant mesothelioma; and (vi) NUT carcinoma. Major pitfalls in evaluating immunohistochemical results are also described.

Keywords: INSM1; WHO classification; immune checkpoint; immunostaining; morphology; non-small cell lung carcinoma (NSCLC); pathology; small cell lung carcinoma (SCLC); thoracic tumor; tyrosine kinase.

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Conflict of interest statement

The author declares no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic of the complex pathways of neuroendocrine differentiation (blue) in lung tumors. INSM1 (red) is inactivated by HES1 and promotes the expression of the three neuroendocrine molecules (CHGA, SYP, and NCAM1) via activation of the transcription factors, ASCL1, and BRN2. INSM1 and ASCL1 activate each other.
Figure 2
Figure 2
(A) Morphology of small cell lung carcinoma (hematoxylin and eosin staining); (B) INSM1 immunostaining (nuclear; positive). Scale bar = 100 µm.
Figure 3
Figure 3
(A) ALK-rearranged lung adenocarcinoma with a signet-ring cell pattern (hematoxylin and eosin staining); (B) ALK immunostaining (cytoplasmic; positive). Scale bar = 100 µm.
Figure 4
Figure 4
(A) Morphology of NUT carcinoma (hematoxylin and eosin staining). Immunohistochemistry of NUT carcinoma; (B) NUT staining (nuclear; positive); (C) p40 staining (nuclear; focally positive); and (D) SYP staining (cytoplasmic; very focally positive). Scale bar = 100 µm.
See this image and copyright information in PMC

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