Concordance between cryobiopsy and forceps biopsy specimens in assessment of immunohistochemistry staining for non-small cell lung carcinoma

Kanako Nishimatsu; Yuji Matsumoto; Jumpei Kashima; Tatsuya Imabayashi; Keigo Uchimura; Hideaki Furuse; Ken Masuda; Yuki Shinno; Yusuke Okuma; Tatsuya Yoshida; Yasushi Goto; Hidehito Horinouchi; Noboru Yamamoto; Takaaki Tsuchida; Yuichiro Ohe; Yasushi Yatabe

doi:10.21037/tlcr-22-621

Concordance between cryobiopsy and forceps biopsy specimens in assessment of immunohistochemistry staining for non-small cell lung carcinoma

Transl Lung Cancer Res. 2023 Jun 30;12(6):1245-1255. doi: 10.21037/tlcr-22-621. Epub 2023 Jun 13.

Authors

Kanako Nishimatsu^{1

2}, Yuji Matsumoto^{1

3}, Jumpei Kashima², Tatsuya Imabayashi¹, Keigo Uchimura¹, Hideaki Furuse¹, Ken Masuda³, Yuki Shinno³, Yusuke Okuma³, Tatsuya Yoshida³, Yasushi Goto³, Hidehito Horinouchi³, Noboru Yamamoto³, Takaaki Tsuchida¹, Yuichiro Ohe³, Yasushi Yatabe²

Affiliations

¹ Respiratory Endoscopy Division, Department of Endoscopy, National Cancer Center Hospital, Tokyo, Japan.
² Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.
³ Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.

Abstract

Background: Cryobiopsy is recently being promoted for biopsy of tumors in the lung periphery in precision medicine for lung cancer; the obtained tissue samples have been reported to be more useful compared to those obtained using forceps, because of the larger volume and higher quality. However, the influence of freezing and thawing of tissues when performing cryobiopsy on the results of immunohistochemistry (IHC) has not been completely understood.

Methods: In this study, consecutive patients who underwent diagnostic bronchoscopy with cryobiopsy for peripheral pulmonary lesions (PPLs) at our institution between June 2017 and November 2021 were reviewed retrospectively. Specimens of diagnosed cases of unresectable or recurrent non-small cell lung carcinoma (NSCLC) were selected. We compared the results of IHC assessment for programmed death-ligand 1 (PD-L1), human epidermal growth factor receptor 2 (HER2), and human epidermal growth factor receptor 3 (HER3) in cryobiopsy specimens versus conventional forceps biopsy specimens from the same site in the same procedure.

Results: Twenty-four of 40 patients were male (60%). The most frequent histologic type of cancer was adenocarcinoma (n=31, 77.5%), followed by NSCLC (n=4, 10%), squamous cell carcinoma (n=3, 7.5%), and others (n=2, 5%). The concordance rates of the tumor proportion scores (TPSs) for PD-L1, IHC score for HER2 and, IHC scores for HER3 were 85%, 72.5%, and 75%, respectively; the weighted kappa were 0.835, 0.637, and 0.697, respectively.

Conclusions: Freezing and thawing associated with cryobiopsy had virtually no effect on the results of IHC. We suggest that cryobiopsy specimens would therefore be ideal for precision medicine and translational research.

Keywords: Cryobiopsy; human epidermal growth factor receptor 2 (HER2); human epidermal growth factor receptor 3 (HER3); immunohistochemistry (IHC); lung cancer.