Small‑cell lung carcinoma. Cytological diagnosis
https://doi.org/10.18027/2224-5057-2022-12-1-36-43
Abstract
The purpose of this article is to evaluate the possibilities of cytology for lung neuroendocrine tumors (small‑cell lung carcinoma and carcinoids) diagnostics. Cytology specimens obtained by bronchoscopy (n = 112), biopsy of metastatic lymph nodes (n = 27) or from pleural effusion (n = 8) were collected within over 1 year from 147 patients and studied. Small-cell lung carcinoma was diagnosed in 143 patients, representing 23,9 % of all lung carcinomas. The proportion of carcinoid tumors was 2,7 % of all neuroendocrine tumors. Typical carcinoid was observed in three cases, and atypical carcinoid — in one case. Cytologic features most significant for cytological diagnosis of small‑cell lung carcinoma and carcinoids were identified (n = 11). Discriminant analysis demonstrated that the proportion of accurate cytological diagnosis of small‑cell lung carcinoma and carcinoids was 96,69 %. Cytology is a reliable method for neuroendocrine tumor diagnosis. Immunocytochemistry with neuroendocrine markers along with light microscopy should be used to differentiate small‑cell lung carcinoma metastases from other tumors and non‑malignant pathology in pleural effusion specimens.
About the Authors
O. G. Grygoruk
Altay Regional Oncology Dispensary; Altay State Medical University
Russian Federation
Russian Federation
Olga G. Grygoruk, MD, DSc Biol, Head of the Cytology Laboratory; Assistant Professor, Department of Biochemistry and Clinical Laboratory Diagnostics
Barnaul
D. A. Tsoi
Altay Regional Oncology Dispensary
Russian Federation
Russian Federation
Dmitry A. Tsoi, Physician of the Cytology Laboratory
Barnaul
L. M. Bazulina
Altay Regional Oncology Dispensary
Russian Federation
Russian Federation
Larisa M. Bazulina, Physician of the Cytology Laboratory
Barnaul
I. V. Vihlyanov
Altay Regional Oncology Dispensary; Altay State Medical University
Russian Federation
Russian Federation
Igor V. Vihlyanov, MD, PhD, DSc, Chief Physician, Altay Regional Oncology Dispensary, Professor of the Department of Radiation Therapy and Radiology with a Course of Continuing Professional Education
Barnaul
References
1. WHO Classification of Tumours Editorial Board. Thoracic tumours. Lyon (France): International Agency for Research on Cancer; 2021. (WHO classification of tumours series, 5th ed.; vol. 5). https://publications.iarc.fr/595.
2. Breitling L. P., Rinke A., Gress T. M. Recent survival trends in high-grade neuroendocrine neoplasms and lung cancer. Neuroendocrinology. 2020; 110 (3 -4): 225 -233. doi: 10.1159/000500883.
3. Varghese A. M., Zakowski M. F., Yu H. A, Won H. H., Riely G. J., Krug L. M., Kris M. G., Rekhtman N., Ladanyi M., Wang L., Berger M. F., Pietanza M. C. Small-cell lung cancers in patients who never smoked cigarettes. J. Thorac. Oncol. 2014; 9 (6):892-6. doi: 10.1097/JTO.0000000000000142.
4. Wang J et al. Genetic predisposition to lung cancer: comprehensive literature integration, meta-analysis, and multiple evidence assessment of candidate-gene association studies. Sci Rep. 2017; 7 (1):8371. doi: 10.1038/s41598-017-07737-0.
5. Quintanal-Villalonga Á., Chan J. M., Yu H. A., Pe’er D., Sawyers C. L., Sen T., Rudin C. Lineage plasticity in cancer: a shared pathway of therapeutic resistance. Nat Rev Clin Oncol. 2020; 17 (6):360 -371. doi: 10.1038/s41571-020-0340-z.
6. Abdel-Rahman O. Changing epidemiology of elderly small cell lung cancer patients over the last 40 years; a SEER database analysis. Clin Respir J. 2018; 12 (3):1093 -1099. doi: 10.1111/crj.12632.
7. Meerbeeck J. P., Fennell D. A., Ruysscher D. K. Small-cell lung cancer. Lancet. 2011; 12; 378 (9804):1741-55. doi: 10.1016/S0140-6736(11)60165-7.
8. Rudin C. M., Brambilla E., Faivre-Finn C., Sage J. Small-cell lung cancer. Nat Rev Dis Primers. 2021; 7 (1): 3. doi: 10.1038/s41572-020-00235-0.
9. Hou JM., Krebs M. G., Lancashire L., Sloane R., Backen A., Swain R. K., Priest L. J. C, Greystoke A., Zhou C., Morris K., Ward T., Blackhall F. H., Dive C. Clinical significance and molecular characteristics of circulating tumor cells and circulating tumor microemboli in patients with small-cell lung cancer. J Clin Oncol. 2012; 30 (5):525-32. doi: 10.1200/JCO.2010.33.3716.
10. Austin J. H., Yip R., D’Souza B. M., Yankelevitz D. F., Henschke C. I. Small-cell carcinoma of the lung detected by CT screening: stage distribution and curability. Lung Cancer. 2012; 76 (3):339-43. doi: 10.1016/j.lungcan.2011.11.017.
11. Früh M., Ruysscher D D, Popat S, Crinò L, Peters S, Felip E. Small-cell lung cancer (SCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013; 24 Suppl 6: vi99-105. doi: 10.1093/annonc/mdt178.
12. Tay R. Y., Fernández-Gutiérrez F., Foy V., Burns K., Pierce J., Morris K., Priest L., Tugwood J., Ashcroft L., Lindsay C. R., Faivre-Finn C., Dive C., Blackhall F. Prognostic value of circulating tumour cells in limited-stage small-cell lung cancer: analysis of the concurrent once-daily versus twice-daily radiotherapy (CONVERT) randomised controlled trial. Ann Oncol. 2019; 30 (7):1114-1120. doi: 10.1093/annonc/mdz122.
13. Grigoruk O. G., Lazarev A. F., Chimitov A. A., Khankhashanova T. D., Bazulina L. M., Shoykhet Ya. N. Identification of cells obtained from blood of oncological patients with hemocytofiltration. Rossiiskii onkologicheskii zhurnal. (Russian Journal of Oncology). 2018; 23 (2): 84–89. (In Russian). doi: 10.18821/1028-9984-2018-23-2-84-89.
14. Stovold R., Blackhall F., Meredith S., Hou J., Dive C., White A. Biomarkers for small cell lung cancer: neuroendocrine, epithelial and circulating tumour cells. Lung Cancer. 2012; 76 (3):263 -8. doi: 10.1016/j.lungcan.2011.11.015.
15. Fernandez-Cuesta L, Perdomo S., Avogbe P., Leblay N., DelhommeT., Gaborieau V., Abedi-Ardekani B., Chanudet E., Olivier M., Zaridze D., Mukeria A., Vilensky M., Holcatova I., Polesel J., Simonato L., Canova C., Lagiou P., Brambilla C., Brambilla E., Byrnes G., Scelo G., Calvez-Kelm F., Foll M., McKay J., Brennan P. Identification of circulating tumor DNA for the early detection of small-cell lung cancer. EBioMedicine. 2016; 10:117-23. doi: 10.1016/j.ebiom.2016.06.032.
16. Almodovar K., Iams W. T., Meador C. B., Zhao Z., York S., Horn L., Yan Y., Hernandez J., Chen H., Shyr Y., Lim L. P., Raymond C. K., Lovly C. M.. Longitudinal Cell-Free DNA Analysis in Patients with Small Cell Lung Cancer Reveals Dynamic Insights into Treatment Efficacy and Disease Relapse. Thorac. Oncol. 2018; 13 (1):112-123. doi: 10.1016/j.jtho.2017.09.1951
17. Travis W. D. Update on small cell carcinoma and its differentiation from squamous cell carcinoma and other non-small cell carcinomas. Mod Pathol. 2012; 25 Suppl 1: S18-30. doi: 10.1038/modpathol.2011.150.
18. Pelosi G., Sonzogni A., Harari S., Albini A., Bresaola E., Marchiò C., Massa F., Righi L., Gatti G., Papanikolaou N., Vijayvergia N., Calabrese F., Papotti M. Classification of pulmonary neuroendocrine tumors: new insights. Transl Lung Cancer Res. 2017; 6 (5):513-529. doi: 10.21037/tlcr.2017.09.04.
19. Mukhopadhyay S., Dermawan J. K.., Lanigan C. P., Farver C. F. Insulinoma-associated protein 1 (INSM1) is a sensitive and highly specific marker of neuroendocrine differentiation in primary lung neoplasms: an immunohistochemical study of 345 cases, including 292 whole-tissue sections. Mod Pathol. 2019;32 (1):100-109. doi: 10.1038/s41379-018-0122-7.
20. Pelosi G., Rindi G., Travis W. D., Papotti M. Ki-67 antigen in lung neuroendocrine tumors: unraveling a role in clinical practice. J Thorac Oncol. 2014; 9 (3):273-84. doi: 10.1097/JTO.0000000000000092.
21. Pelosi G., Travis W. The Ki-67 antigen in the new 2021 World Health Organization classification of lung neuroendocrine neoplasms. Pathologica. 2021; 113 (5):377-387. doi: 10.32074/1591-951X-542.
22. Travis W. D. Pathology and diagnosis of neuroendocrine tumors: lung neuroendocrine. Thorac Surg Clin. 2014; 24 (3): 257-66. doi: 10.1016/j.thorsurg.2014.04.001
23. Grigoruk O. G., Pupkova E. I., Bazulina L. M., Lazarev A. F. The usage of cytological material for diagnostics of lung cancer. Malignant Tumours 2017; 4: 13–20. doi: 10.18027/2224–5057–2017–7–4–13–20. (In Russ.)
24. Cytology: diagnostic principles and clinical correlates, Fifth edition isbn: 978-0-323-636-0 Copyright © 2021 by Elsevier Inc. 102-106.
25. Brambilla E., Moro D., Veale D., Brichon P. Y., Stoebner P., Paramelle B., Brambilla C. Basal cell (basaloid) carcinoma of the lung: a new morphologic and phenotypic entity with separate prognostic significance. Hum Pathol. 1992; 23 (9):993-1003. doi: 10.1016/0046-8177(92)90260-a.
26. Kalhor N., Zander D. S., Liu J. TTF-1 and p63 for distinguishing pulmonary small-cell carcinoma from poorly differentiated squamous cell carcinoma in previously Pap-stained cytologic material. Mod Pathol. 2006; 19 (8):1117–1123. doi: 10.1038/modpathol.3800629.
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For citations:
Grygoruk O.G., Tsoi D.A., Bazulina L.M., Vihlyanov I.V. Small‑cell lung carcinoma. Cytological diagnosis. Malignant tumours. 2022;12(1):36-43. (In Russ.) https://doi.org/10.18027/2224-5057-2022-12-1-36-43
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