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Detection of ROS1-positive non-small cell lung cancer on cytological specimens using immunocytochemistry

Tatjana Vlajnic1, Spasenija Savic1, Audrey Barascud1

  • 1Institute of Pathology, University Hospital Basel, Basel, Switzerland.

Cancer Cytopathology
|February 17, 2018
PubMed
Abstract

Insights

ROS1 immunocytochemistry (ICC) accurately detects ROS1 rearrangements in non-small cell lung cancer (NSCLC) cytology specimens. This rapid screening method is ideal for identifying patients who may benefit from targeted therapy.

Area of Science:

  • Oncology
  • Molecular Diagnostics
  • Cytopathology

Background:

  • ROS1 gene rearrangements occur in 1-2% of non-small cell lung cancers (NSCLC) and are key drivers for targeted therapy.
  • ROS1 testing is crucial for NSCLC diagnosis, with Fluorescence In Situ Hybridization (FISH) being a common method.
  • Cytological specimens are often used for NSCLC diagnosis, necessitating predictive marker testing on these samples.

Purpose of the Study:

  • To evaluate the accuracy of ROS1 immunocytochemistry (ICC) on cytological specimens for detecting ROS1 rearrangements in NSCLC.
  • To assess ICC as a potential screening tool for ROS1-positive NSCLC.

Main Methods:

  • Prospective study involving 295 NSCLC patients.
  • ROS1 ICC performed on non-cell block cytological specimens using the D4D6 antibody on an automated immunostainer.
  • Comparison of ICC results with FISH or next-generation sequencing (NGS) for confirmation.

Main Results:

  • ICC demonstrated 100% sensitivity, specificity, and predictive values for detecting ROS1 rearrangements.
  • All 13 ROS1-rearranged NSCLC cases were correctly identified by ICC.
  • 208 out of 282 ICC-negative cases were confirmed, showing high concordance.

Conclusions:

  • ROS1 ICC is a highly accurate method for detecting ROS1 rearrangements in NSCLC.
  • ICC is a rapid and cost-effective screening tool for ROS1 rearrangements, especially in cytology.
  • Positive or equivocal ICC results can be confirmed with FISH or molecular tests.
Keywords:
ROS1cytologyimmunocytochemistrylung cancerpredictive marker

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