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Carrefour, Palais des Congrès, Paris, Lundi 4 novembre 2019
Conférence de la Société Française de Cytologie Clinique
CYTOPATHOLOGIEMOLECULAIRE
Philippe Vielh MD, PhD, FIAC
Email: ph.vielh@outlook.com
Conflit d’intérêt : aucun
Acta Cytologica 2007
Bibbo et al. Acta Cytol 2007;51:123–152
Acta Cytologica 2007-2017
Schmitt et al. Acta Cytologica 2017;61:373–407
Acta Cytologica 2007-2017
◼ Role of morphology:◼ Do you think morphological features will still play and important role
10 years from now?
◼ Role of imaging techniques: FNA under the guidance of several imaging techniques has become an important component of the workup of many lesions. The issues discussed were:◼ Who performs FNA?
◼ What is the role of core needle biopsies?
◼ Can the imaging techniques replace cytology in the diagnosis?
Acta Cytologica 2007-2017
◼ Role of immunocytochemistry: ICC has become an important adjunct for cytological diagnosis◼ The use of different preparations and fixatives are a problem for
standardization
◼ Role of clinical cytogenetics (FISH) and of moleculartechniques: a variety of molecular assays for the detectionof gene mutations, amplifications and DNA instability have demonstrated clinical utility in cytology. Issues were:◼ Applications of these techniques
◼ Questions if targeted therapies will boost their use in cytology
◼ Prediction and advances and challenges in their implementation
Cytoponction vs biopsie
S Roy-Chowdhuri et al. Modern Pathology (2017) 30, 499–508
Cytoponction vs biopsie
Roy-Chowdhuri S et al. Modern Pathology (2017) 30, 499–508
Cytoponction vs biopsie
Roy-Chowdhuri S et al. Modern Pathology (2017) 30, 499–508
Rôle du pathologiste
da Cunha Santos G et al. Cytopathology 2018;29:125-32.
Cancers pulmonaires
Jain D et al. Arch Pathol Lab Med. 2018;142:253-62
Figure 1. Lymph node stations accessible by endobronchial ultrasound–guided transbronchial needle aspirate,
which include paratracheal lymph node stations (levels 2R, 2L, 4R, and 4L), the subcarinal lymph node (level 7),
and the hilar, interlobar, and lobar lymph nodes (levels 10, 11, and 12).
Evaluation immediate (ROSE)
Jain D et al. Arch Pathol Lab Med. 2018;142:253-62
Choix des colorations
Jain D et al. Arch Pathol Lab Med. 2018;142:253–262
Pathologiste interventionnel
Jain D et al. Arch Pathol Lab Med. 2018;142:1127-33
Importance du pré-analytique
Jain D et al. Arch Pathol Lab Med. 2018;142:1127-33
CAP-IASLC-AMP guideline
Lindeman N, et al. Arch Pathol Lab Med. 2018;142:321–346
Multiplicité des cibles
Jain D et al. Arch Pathol Lab Med. 2018;142:1127-33
Multiplicité des techniques
Thunnissen E et al. Arch Pathol Lab Med. 2018;142:408-19
Multiplicité des techniques
Jain D et al. Arch Pathol Lab Med. 2018;142:1127-33
ICC? FISH? NGS?
◼ ICC:◼ Anticorps anti-ALK: 5A4, D5F3, 1A4/1H7 (?)…
◼ Anticorps anti-ROS1: D4D6, EPMGHR2 (?)…
◼ Anticorps anPD-L1: 28-8, 22C3, SP142, SP263…
◼ FISH: sondes « break apart » (« split apart »)
◼ NGS: mutations…
Logistique
Roy-Chowdhuri S et al. Modern Pathology (2018) 31:1036-45
Ré-arrangement ALK
Pisapia P et al. Cancer Cytopathol 2017;125:817-30.
Ré-arrangement ROS1
Pisapia P et al. Cancer Cytopathol 2017;125:817-30.
Marquage anti-PD-L1
Marquage anti-PD-L1
Vigliar E et al. J Clin Pathol 2019;72:412-17
NGS: technologie
Pisapia P et al. Cancer Cytopathol 2017;125:817-30.
NGS: organisation
Roy-Chowdhuri S et al. Cancer Cytopathol 2017;125:236-44
NGS: intégration
Figure 2. CTS reporting. (A) CTS report workflow showing how several ancillary studies including molecular results can be generated into a
simplified report with a synoptic worksheet tool in the LIS. (B) Example of a CTS report that summarizes all of the molecular data in a single
addendum report. ALK, anaplastic lymphoma kinase; CTS, comprehensive theranostic summary; EGFR, epidermal growth factor receptor;
KRAS, Kirsten rat sarcoma viral oncogene; FISH, fluorescence in situ hybridization; IHC, immunohistochemistry; LIS, laboratory
information system; PCR, polymerase chain reaction; PD-L1, programmed death ligand 1; US, ultrasound.
Roy-Chowdhuri S et al. Cancer Cytopathol 2017;125:236-44
Contrôles de qualité
Malapelle U et al. Cancer Cytopathol 2017;125:615-26
Contrôles de qualité
Pisapia P et al. Cancer Cytopathol 2019;127(5):285-296
Alternatives: surnageant
Roy-Chowdhuri S et al. Modern Pathology (2018) 31:1036–1045
Alternatives: surnageant
Hannigan B et al. Annals of Oncology 30: 963–969, 2019
Alternatives: surnageant
Hannigan B et al. Annals of Oncology 30: 963–969, 2019
Alternatives: surnageant
Hannigan B et al. Annals of Oncology 30: 963–969, 2019
Alternatives: préparations colorées
Piqueret-Stephan L et al. Cancer Cytopathol 2016;124:241-53
Alternatives: préparations colorées
Piqueret-Stephan L et al. Cancer Cytopathol 2016;124:241-53
Alternatives: préparations colorées
Piqueret-Stephan L et al. Cancer Cytopathol 2016;124:241-53
Alternatives: préparations colorées
De Luca C, et al. J Clin Pathol 2019;72:609–614.
ARNs: NanoString
Sgariglia R, et al. J Clin Pathol 2017;70:803–806
ARNs: NanoString
Pisapia P et al. Cancer Cytopathol 2017;125:817-30.
◼ MERCI !!!
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