Cell pellet from fixative medium of transbronchial lung biopsy sample improves lung cancer ancillary test

Juhong Jiang; Chunli Tang; Yuqin Li; Zeyun Lin; Zhi Li; Chengzhi Zhou; Yingying Gu; Ping He; Qing Tang; Yuxin Zhang; Qiuhua Deng; Yimin Ge; Wenhua Liang; Jianxing He

doi:10.1016/j.lungcan.2022.11.012

Cell pellet from fixative medium of transbronchial lung biopsy sample improves lung cancer ancillary test

Juhong Jiang, Chunli Tang, Yuqin Li, Zeyun Lin, Zhi Li, Chengzhi Zhou, Yingying Gu, Ping He, Qing Tang, Yuxin Zhang, Qiuhua Deng, Yimin Ge, Wenhua Liang, Jianxing He

Research output: Contribution to journal › Article › peer-review

Abstract

Objectives: Lung cancer tissue obtained using small biopsies are relatively fragile, leaving behind some tiny tissue fragments or cell clusters in the fixative medium that are difficult to collect for processing as a paraffin-embedded tissue block. Usually, the cellular component of the residual fixative medium is discarded as medical waste as per routine laboratory protocol. No protocol exists for utilizing the cellular component of the residual fixative medium after processing the tissue blocks to improve lung cancer ancillary testing. This study aimed to undercover the potential value of these samples for lung cancer diagnosis and targeted therapy development. Materials and Methods: A protocol was developed for cell pellet sample collection from the residual fixative medium of a transbronchial forceps lung biopsy sample. Tumour cell number and fraction in a paired cell pellet and matching formalin-fixed paraffin-embedded tissue section were evaluated from 324 non-smallcell lung carcinoma (NSCLC) cases. We defined the adequacy of the cell pellet for molecular analysis as ≥ 200 tumour cells and ≥ 10 % tumour cells. Real-time polymerase chain reaction and next-generation sequencing were performed on adequate cell pellet samples. Results: We discovered that the fixative medium of most transbronchial forceps lung biopsy samples was enriched in tumour cells. Among 324 biopsy samples, 70 (21.6%) exhibited inadequate formalin-fixed paraffin-embedded tissue sections, whereas 53 (75.7%) yielded adequate cell pellet samples. Somatic mutations detected in the formalin-fixed paraffin-embedded tissue section samples were also detected in the matching cell pellets. Conclusions: Cell pellets collected from the fixative medium of thoracic small biopsies are a beneficial supplemental material for ancillary testing. Combined use of cell pellets with traditional tissue-based samples can enhance the detection rate of informative mutations in patients with advanced NSCLC.

Original language	English (US)
Pages (from-to)	9-16
Number of pages	8
Journal	Lung Cancer
Volume	175
DOIs	https://doi.org/10.1016/j.lungcan.2022.11.012
State	Published - Jan 2023

Keywords

Ancillary testing
Cell pellet
Fixative medium
Mutation detection
Non-small cell lung carcinoma
Transbronchial forceps lung biopsy
Humans
Lung Neoplasms/diagnosis
Formaldehyde
Carcinoma, Non-Small-Cell Lung/diagnosis
Biopsy/methods
Fixatives
Lung/pathology
Paraffin Embedding/methods
Mutation

ASJC Scopus subject areas

Oncology
Pulmonary and Respiratory Medicine
Cancer Research

Access to Document

10.1016/j.lungcan.2022.11.012

Cite this

@article{a5947d720ad943d4a3d4837ac0cfc786,

title = "Cell pellet from fixative medium of transbronchial lung biopsy sample improves lung cancer ancillary test",

abstract = "Objectives: Lung cancer tissue obtained using small biopsies are relatively fragile, leaving behind some tiny tissue fragments or cell clusters in the fixative medium that are difficult to collect for processing as a paraffin-embedded tissue block. Usually, the cellular component of the residual fixative medium is discarded as medical waste as per routine laboratory protocol. No protocol exists for utilizing the cellular component of the residual fixative medium after processing the tissue blocks to improve lung cancer ancillary testing. This study aimed to undercover the potential value of these samples for lung cancer diagnosis and targeted therapy development. Materials and Methods: A protocol was developed for cell pellet sample collection from the residual fixative medium of a transbronchial forceps lung biopsy sample. Tumour cell number and fraction in a paired cell pellet and matching formalin-fixed paraffin-embedded tissue section were evaluated from 324 non-smallcell lung carcinoma (NSCLC) cases. We defined the adequacy of the cell pellet for molecular analysis as ≥ 200 tumour cells and ≥ 10 % tumour cells. Real-time polymerase chain reaction and next-generation sequencing were performed on adequate cell pellet samples. Results: We discovered that the fixative medium of most transbronchial forceps lung biopsy samples was enriched in tumour cells. Among 324 biopsy samples, 70 (21.6%) exhibited inadequate formalin-fixed paraffin-embedded tissue sections, whereas 53 (75.7%) yielded adequate cell pellet samples. Somatic mutations detected in the formalin-fixed paraffin-embedded tissue section samples were also detected in the matching cell pellets. Conclusions: Cell pellets collected from the fixative medium of thoracic small biopsies are a beneficial supplemental material for ancillary testing. Combined use of cell pellets with traditional tissue-based samples can enhance the detection rate of informative mutations in patients with advanced NSCLC.",

keywords = "Ancillary testing, Cell pellet, Fixative medium, Mutation detection, Non-small cell lung carcinoma, Transbronchial forceps lung biopsy, Humans, Lung Neoplasms/diagnosis, Formaldehyde, Carcinoma, Non-Small-Cell Lung/diagnosis, Biopsy/methods, Fixatives, Lung/pathology, Paraffin Embedding/methods, Mutation",

author = "Juhong Jiang and Chunli Tang and Yuqin Li and Zeyun Lin and Zhi Li and Chengzhi Zhou and Yingying Gu and Ping He and Qing Tang and Yuxin Zhang and Qiuhua Deng and Yimin Ge and Wenhua Liang and Jianxing He",

note = "Funding Information: This work was supported by the Open Project of the State Key Laboratory of Respiratory Disease [grant number SKLRD-OP-202205] and the National Natural Sciences Foundation of China [grant number 81772814]. The funding sources had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Funding Information: We would like to thank Editage (www.editage.cn) for English language editing. This work was supported by the Open Project of the State Key Laboratory of Respiratory Disease [grant number SKLRD-OP-202205] and the National Natural Sciences Foundation of China [grant number 81772814]. The funding sources had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. All authors confirm adherence to the policy. The data that support the findings of this study are available from the corresponding author upon request. The authors have no conflicts of interest to declare. This study was approved by the institutional review board of the First Affiliated Hospital of Guangzhou Medical University (reference number: 2021-70; approval date: August 16, 2021). Procedures involving human subjects were in accordance with the Declaration of Helsinki, 1975, as revised in 1983. JJ, ZL, CZ, YG, and JH conceived and designed the study. CT, QT, and YZ carried out the biopsy procedure. YL and ZL prepared the slides. JJ and YL evaluated the Slides. QD carried out molecular test. JJ and WL wrote the manuscript. All authors had final approval of the submitted and published versions. Publisher Copyright: {\textcopyright} 2022 Elsevier B.V.",

year = "2023",

month = jan,

doi = "10.1016/j.lungcan.2022.11.012",

language = "English (US)",

volume = "175",

pages = "9--16",

journal = "Lung Cancer",

issn = "0169-5002",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Cell pellet from fixative medium of transbronchial lung biopsy sample improves lung cancer ancillary test

AU - Jiang, Juhong

AU - Tang, Chunli

AU - Li, Yuqin

AU - Lin, Zeyun

AU - Li, Zhi

AU - Zhou, Chengzhi

AU - Gu, Yingying

AU - He, Ping

AU - Tang, Qing

AU - Zhang, Yuxin

AU - Deng, Qiuhua

AU - Ge, Yimin

AU - Liang, Wenhua

AU - He, Jianxing

N1 - Funding Information: This work was supported by the Open Project of the State Key Laboratory of Respiratory Disease [grant number SKLRD-OP-202205] and the National Natural Sciences Foundation of China [grant number 81772814]. The funding sources had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Funding Information: We would like to thank Editage (www.editage.cn) for English language editing. This work was supported by the Open Project of the State Key Laboratory of Respiratory Disease [grant number SKLRD-OP-202205] and the National Natural Sciences Foundation of China [grant number 81772814]. The funding sources had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. All authors confirm adherence to the policy. The data that support the findings of this study are available from the corresponding author upon request. The authors have no conflicts of interest to declare. This study was approved by the institutional review board of the First Affiliated Hospital of Guangzhou Medical University (reference number: 2021-70; approval date: August 16, 2021). Procedures involving human subjects were in accordance with the Declaration of Helsinki, 1975, as revised in 1983. JJ, ZL, CZ, YG, and JH conceived and designed the study. CT, QT, and YZ carried out the biopsy procedure. YL and ZL prepared the slides. JJ and YL evaluated the Slides. QD carried out molecular test. JJ and WL wrote the manuscript. All authors had final approval of the submitted and published versions. Publisher Copyright: © 2022 Elsevier B.V.

PY - 2023/1

Y1 - 2023/1

N2 - Objectives: Lung cancer tissue obtained using small biopsies are relatively fragile, leaving behind some tiny tissue fragments or cell clusters in the fixative medium that are difficult to collect for processing as a paraffin-embedded tissue block. Usually, the cellular component of the residual fixative medium is discarded as medical waste as per routine laboratory protocol. No protocol exists for utilizing the cellular component of the residual fixative medium after processing the tissue blocks to improve lung cancer ancillary testing. This study aimed to undercover the potential value of these samples for lung cancer diagnosis and targeted therapy development. Materials and Methods: A protocol was developed for cell pellet sample collection from the residual fixative medium of a transbronchial forceps lung biopsy sample. Tumour cell number and fraction in a paired cell pellet and matching formalin-fixed paraffin-embedded tissue section were evaluated from 324 non-smallcell lung carcinoma (NSCLC) cases. We defined the adequacy of the cell pellet for molecular analysis as ≥ 200 tumour cells and ≥ 10 % tumour cells. Real-time polymerase chain reaction and next-generation sequencing were performed on adequate cell pellet samples. Results: We discovered that the fixative medium of most transbronchial forceps lung biopsy samples was enriched in tumour cells. Among 324 biopsy samples, 70 (21.6%) exhibited inadequate formalin-fixed paraffin-embedded tissue sections, whereas 53 (75.7%) yielded adequate cell pellet samples. Somatic mutations detected in the formalin-fixed paraffin-embedded tissue section samples were also detected in the matching cell pellets. Conclusions: Cell pellets collected from the fixative medium of thoracic small biopsies are a beneficial supplemental material for ancillary testing. Combined use of cell pellets with traditional tissue-based samples can enhance the detection rate of informative mutations in patients with advanced NSCLC.

AB - Objectives: Lung cancer tissue obtained using small biopsies are relatively fragile, leaving behind some tiny tissue fragments or cell clusters in the fixative medium that are difficult to collect for processing as a paraffin-embedded tissue block. Usually, the cellular component of the residual fixative medium is discarded as medical waste as per routine laboratory protocol. No protocol exists for utilizing the cellular component of the residual fixative medium after processing the tissue blocks to improve lung cancer ancillary testing. This study aimed to undercover the potential value of these samples for lung cancer diagnosis and targeted therapy development. Materials and Methods: A protocol was developed for cell pellet sample collection from the residual fixative medium of a transbronchial forceps lung biopsy sample. Tumour cell number and fraction in a paired cell pellet and matching formalin-fixed paraffin-embedded tissue section were evaluated from 324 non-smallcell lung carcinoma (NSCLC) cases. We defined the adequacy of the cell pellet for molecular analysis as ≥ 200 tumour cells and ≥ 10 % tumour cells. Real-time polymerase chain reaction and next-generation sequencing were performed on adequate cell pellet samples. Results: We discovered that the fixative medium of most transbronchial forceps lung biopsy samples was enriched in tumour cells. Among 324 biopsy samples, 70 (21.6%) exhibited inadequate formalin-fixed paraffin-embedded tissue sections, whereas 53 (75.7%) yielded adequate cell pellet samples. Somatic mutations detected in the formalin-fixed paraffin-embedded tissue section samples were also detected in the matching cell pellets. Conclusions: Cell pellets collected from the fixative medium of thoracic small biopsies are a beneficial supplemental material for ancillary testing. Combined use of cell pellets with traditional tissue-based samples can enhance the detection rate of informative mutations in patients with advanced NSCLC.

KW - Ancillary testing

KW - Cell pellet

KW - Fixative medium

KW - Mutation detection

KW - Non-small cell lung carcinoma

KW - Transbronchial forceps lung biopsy

KW - Humans

KW - Lung Neoplasms/diagnosis

KW - Formaldehyde

KW - Carcinoma, Non-Small-Cell Lung/diagnosis

KW - Biopsy/methods

KW - Fixatives

KW - Lung/pathology

KW - Paraffin Embedding/methods

KW - Mutation

UR - http://www.scopus.com/inward/record.url?scp=85142542415&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85142542415&partnerID=8YFLogxK

U2 - 10.1016/j.lungcan.2022.11.012

DO - 10.1016/j.lungcan.2022.11.012

M3 - Article

C2 - 36436242

AN - SCOPUS:85142542415

SN - 0169-5002

VL - 175

SP - 9

EP - 16

JO - Lung Cancer

JF - Lung Cancer

ER -

Cell pellet from fixative medium of transbronchial lung biopsy sample improves lung cancer ancillary test

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this