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Updated: May 16, 2026
Multiplex Immunohistochemistry Staining for Paraffin-embedded Lung Cancer Tissue
Published on: November 21, 2023
Molecular characterization by immunocytochemistry of lung adenocarcinoma on cytology specimens
Andre L Moreira1, Adnan Hasanovic
1Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. moreiraa@mskcc.org
Abstract:
The discovery of targetable driver mutations in pulmonary adenocarcinoma has revolutionized the field of thoracic oncology by the introduction of oral small molecule tyrosine kinase inhibitors that target specific EGFR mutations and EML-4/ALK rearrangement. Therefore, testing for EGFR gene mutations and ALK rearrangements has become part of everyday clinical practice. The majority of lung cancer patients present at an advanced stage, where small biopsy and cytology specimens are often the only available material for diagnostic workup and molecular characterization. Mutation testing has become the standard of care. Nonetheless, the technical complexity and relative high cost of the test have challenged the widespread use of molecular techniques in everyday clinical settings. Recently, antibodies to specific molecular alterations have become available and have the potential to become instruments for the molecular characterization of tumors. In this review article we will discuss practical issues in molecular characterization of lung adenocarcinoma on cytology material and the use of immunocytochemical stains for the detection of mutant protein as an alternative or adjunct to molecular techniques.
Insights
Targetable mutations in lung adenocarcinoma transformed thoracic oncology. Immunocytochemical stains offer a practical alternative for detecting mutant proteins in cytology specimens, complementing molecular techniques.
Area of Science:
- Oncology
- Molecular Pathology
Background:
- Targetable driver mutations in pulmonary adenocarcinoma have led to targeted therapies like tyrosine kinase inhibitors.
- EGFR mutations and ALK rearrangements are key targets, making their testing standard in clinical practice.
- Small biopsy and cytology specimens are often used for molecular characterization in advanced lung cancer.
Purpose of the Study:
- To discuss practical challenges in molecular characterization of lung adenocarcinoma using cytology material.
- To explore the use of immunocytochemical stains for detecting mutant proteins as an alternative or adjunct to molecular techniques.
Main Methods:
- Review of current literature on molecular characterization of lung adenocarcinoma.
- Discussion of immunocytochemistry as a diagnostic tool for specific molecular alterations.
Main Results:
- Molecular testing for EGFR mutations and ALK rearrangements is standard but faces challenges in cost and complexity.
- Antibodies for specific molecular alterations are emerging as potential tools for tumor characterization.
- Immunocytochemistry presents a viable option for detecting mutant proteins in cytology samples.
Conclusions:
- Immunocytochemistry can serve as a practical and accessible method for molecular characterization of lung adenocarcinoma.
- This approach can complement or potentially replace traditional molecular techniques in certain clinical settings.
- Further validation of immunocytochemical stains is crucial for widespread adoption in routine diagnostics.
