Comparison of Programmed Death Ligand-1 Immunohistochemical Staining Between Endobronchial Ultrasound Transbronchial Needle Aspiration and Resected Lung Cancer Specimens

Kenneth K. Sakata, David Eric Midthun, John J. Mullon, Ryan M. Kern, Darlene R. Nelson, Eric Edell, Dante N. Schiavo, James R. Jett, Marie Christine Aubry

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: In advanced non-small cell lung cancer (NSCLC), small biopsy specimens from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are often the only available material from cancer tissue for the analysis of programmed death ligand-1 (PD-L1) expression. We aim to assess the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PD-L1 expression at ≥ 1% and ≥ 50% on EBUS-TBNA samples compared with their corresponding surgically resected tumor. Methods: We retrospectively reviewed all patients who underwent EBUS-TBNA followed by surgical resection of NSCLC between July 2006 and September 2016. Demographic information and periprocedural/surgical data were collected. The archived specimens were retrieved and assessed for PD-L1. A positive PD-L1 stain was defined using two separate cutoff points: ≥ 1% and ≥ 50% of tumor cell positivity. EBUS-TBNA aspirates were compared with the surgically resected specimen to calculate the sensitivity, specificity, PPV, and NPV. Results: Sixty-one patients were included. For PD-L1 ≥ 1%, the sensitivity, specificity, PPV, and NPV were 72%, 100%, 100%, and 80%, respectively. For PD-L1 ≥ 50%, the sensitivity, specificity, PPV, and NPV were 47%, 93%, 70%, and 84%, respectively. The concordance rates for PD-L1 ≥ 1% and ≥ 50% were 87% and 82%, respectively. Conclusions: A PD-L1 cutoff of ≥ 1% on EBUS-TBNA has a strong correlation with resected tumor specimen. For PD-L1 ≥ 50%, there is a significant decrease in the sensitivity and PPV of EBUS-TBNA specimen when compared with resected tumor. When analyzing for PD-L1 expression using a cutoff of ≥ 50%, EBUS-TBNA specimens may misclassify the status of PD-L1.

Original languageEnglish (US)
Pages (from-to)827-837
Number of pages11
JournalChest
Volume154
Issue number4
DOIs
StatePublished - Oct 1 2018

Fingerprint

Needles
Lung Neoplasms
Staining and Labeling
Ligands
Sensitivity and Specificity
Neoplasms
Non-Small Cell Lung Carcinoma
Coloring Agents
Demography
Biopsy
Mortality

Keywords

  • endobronchial ultrasound-guided transbronchial needle aspiration
  • immunotherapy
  • non-small cell lung cancer
  • programmed death ligand-1
  • programmed death-1

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of Programmed Death Ligand-1 Immunohistochemical Staining Between Endobronchial Ultrasound Transbronchial Needle Aspiration and Resected Lung Cancer Specimens. / Sakata, Kenneth K.; Midthun, David Eric; Mullon, John J.; Kern, Ryan M.; Nelson, Darlene R.; Edell, Eric; Schiavo, Dante N.; Jett, James R.; Aubry, Marie Christine.

In: Chest, Vol. 154, No. 4, 01.10.2018, p. 827-837.

Research output: Contribution to journalArticle

Sakata, Kenneth K. ; Midthun, David Eric ; Mullon, John J. ; Kern, Ryan M. ; Nelson, Darlene R. ; Edell, Eric ; Schiavo, Dante N. ; Jett, James R. ; Aubry, Marie Christine. / Comparison of Programmed Death Ligand-1 Immunohistochemical Staining Between Endobronchial Ultrasound Transbronchial Needle Aspiration and Resected Lung Cancer Specimens. In: Chest. 2018 ; Vol. 154, No. 4. pp. 827-837.
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title = "Comparison of Programmed Death Ligand-1 Immunohistochemical Staining Between Endobronchial Ultrasound Transbronchial Needle Aspiration and Resected Lung Cancer Specimens",
abstract = "Background: In advanced non-small cell lung cancer (NSCLC), small biopsy specimens from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are often the only available material from cancer tissue for the analysis of programmed death ligand-1 (PD-L1) expression. We aim to assess the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PD-L1 expression at ≥ 1{\%} and ≥ 50{\%} on EBUS-TBNA samples compared with their corresponding surgically resected tumor. Methods: We retrospectively reviewed all patients who underwent EBUS-TBNA followed by surgical resection of NSCLC between July 2006 and September 2016. Demographic information and periprocedural/surgical data were collected. The archived specimens were retrieved and assessed for PD-L1. A positive PD-L1 stain was defined using two separate cutoff points: ≥ 1{\%} and ≥ 50{\%} of tumor cell positivity. EBUS-TBNA aspirates were compared with the surgically resected specimen to calculate the sensitivity, specificity, PPV, and NPV. Results: Sixty-one patients were included. For PD-L1 ≥ 1{\%}, the sensitivity, specificity, PPV, and NPV were 72{\%}, 100{\%}, 100{\%}, and 80{\%}, respectively. For PD-L1 ≥ 50{\%}, the sensitivity, specificity, PPV, and NPV were 47{\%}, 93{\%}, 70{\%}, and 84{\%}, respectively. The concordance rates for PD-L1 ≥ 1{\%} and ≥ 50{\%} were 87{\%} and 82{\%}, respectively. Conclusions: A PD-L1 cutoff of ≥ 1{\%} on EBUS-TBNA has a strong correlation with resected tumor specimen. For PD-L1 ≥ 50{\%}, there is a significant decrease in the sensitivity and PPV of EBUS-TBNA specimen when compared with resected tumor. When analyzing for PD-L1 expression using a cutoff of ≥ 50{\%}, EBUS-TBNA specimens may misclassify the status of PD-L1.",
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author = "Sakata, {Kenneth K.} and Midthun, {David Eric} and Mullon, {John J.} and Kern, {Ryan M.} and Nelson, {Darlene R.} and Eric Edell and Schiavo, {Dante N.} and Jett, {James R.} and Aubry, {Marie Christine}",
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T1 - Comparison of Programmed Death Ligand-1 Immunohistochemical Staining Between Endobronchial Ultrasound Transbronchial Needle Aspiration and Resected Lung Cancer Specimens

AU - Sakata, Kenneth K.

AU - Midthun, David Eric

AU - Mullon, John J.

AU - Kern, Ryan M.

AU - Nelson, Darlene R.

AU - Edell, Eric

AU - Schiavo, Dante N.

AU - Jett, James R.

AU - Aubry, Marie Christine

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background: In advanced non-small cell lung cancer (NSCLC), small biopsy specimens from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are often the only available material from cancer tissue for the analysis of programmed death ligand-1 (PD-L1) expression. We aim to assess the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PD-L1 expression at ≥ 1% and ≥ 50% on EBUS-TBNA samples compared with their corresponding surgically resected tumor. Methods: We retrospectively reviewed all patients who underwent EBUS-TBNA followed by surgical resection of NSCLC between July 2006 and September 2016. Demographic information and periprocedural/surgical data were collected. The archived specimens were retrieved and assessed for PD-L1. A positive PD-L1 stain was defined using two separate cutoff points: ≥ 1% and ≥ 50% of tumor cell positivity. EBUS-TBNA aspirates were compared with the surgically resected specimen to calculate the sensitivity, specificity, PPV, and NPV. Results: Sixty-one patients were included. For PD-L1 ≥ 1%, the sensitivity, specificity, PPV, and NPV were 72%, 100%, 100%, and 80%, respectively. For PD-L1 ≥ 50%, the sensitivity, specificity, PPV, and NPV were 47%, 93%, 70%, and 84%, respectively. The concordance rates for PD-L1 ≥ 1% and ≥ 50% were 87% and 82%, respectively. Conclusions: A PD-L1 cutoff of ≥ 1% on EBUS-TBNA has a strong correlation with resected tumor specimen. For PD-L1 ≥ 50%, there is a significant decrease in the sensitivity and PPV of EBUS-TBNA specimen when compared with resected tumor. When analyzing for PD-L1 expression using a cutoff of ≥ 50%, EBUS-TBNA specimens may misclassify the status of PD-L1.

AB - Background: In advanced non-small cell lung cancer (NSCLC), small biopsy specimens from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are often the only available material from cancer tissue for the analysis of programmed death ligand-1 (PD-L1) expression. We aim to assess the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PD-L1 expression at ≥ 1% and ≥ 50% on EBUS-TBNA samples compared with their corresponding surgically resected tumor. Methods: We retrospectively reviewed all patients who underwent EBUS-TBNA followed by surgical resection of NSCLC between July 2006 and September 2016. Demographic information and periprocedural/surgical data were collected. The archived specimens were retrieved and assessed for PD-L1. A positive PD-L1 stain was defined using two separate cutoff points: ≥ 1% and ≥ 50% of tumor cell positivity. EBUS-TBNA aspirates were compared with the surgically resected specimen to calculate the sensitivity, specificity, PPV, and NPV. Results: Sixty-one patients were included. For PD-L1 ≥ 1%, the sensitivity, specificity, PPV, and NPV were 72%, 100%, 100%, and 80%, respectively. For PD-L1 ≥ 50%, the sensitivity, specificity, PPV, and NPV were 47%, 93%, 70%, and 84%, respectively. The concordance rates for PD-L1 ≥ 1% and ≥ 50% were 87% and 82%, respectively. Conclusions: A PD-L1 cutoff of ≥ 1% on EBUS-TBNA has a strong correlation with resected tumor specimen. For PD-L1 ≥ 50%, there is a significant decrease in the sensitivity and PPV of EBUS-TBNA specimen when compared with resected tumor. When analyzing for PD-L1 expression using a cutoff of ≥ 50%, EBUS-TBNA specimens may misclassify the status of PD-L1.

KW - endobronchial ultrasound-guided transbronchial needle aspiration

KW - immunotherapy

KW - non-small cell lung cancer

KW - programmed death ligand-1

KW - programmed death-1

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