Molecular/biomarker testing in lung cytology: A practical approach

Area of Science:

• Oncology
• Pathology
• Cytopathology

Background:

• Advances in understanding lung cancer molecular mechanisms and genomic alterations are transforming pathology.
• Pathologists play a crucial role in managing non-small cell lung cancer (NSCLC).
• Cytopathology faces challenges in maximizing diagnostic yield from limited samples.

Purpose of the Study:

• To provide concepts for exploiting cytological samples for comprehensive diagnosis.
• To guide the use of cytologic samples for essential ancillary testing.
• To address the evolving landscape of lung cytopathology.

Main Methods:

• Review of current practices in lung cancer pathology and cytopathology.
• Discussion of molecular mechanisms and genomic alterations in NSCLC.
• Emphasis on the utilization of cytologic samples and small biopsies.

Main Results:

• Cytologic samples can be effectively used for both diagnosis and ancillary biomarker testing.
• A paradigm shift in sample handling is necessary to accommodate biomarker needs.
• New diagnostic techniques and tools are continuously being implemented in lung cytopathology.

Conclusions:

• Cytological samples are valuable resources for comprehensive lung cancer diagnosis and personalized treatment strategies.
• Effective utilization of cytopathology is key to "doing more with less" in NSCLC management.
• Pathologists must adapt to new techniques and challenges in lung cytopathology to meet the growing demand for predictive biomarkers.