Abstract
The rapid integration of molecular diagnostic assays into pathology has revolutionized the practice of diagnostic cytopathology by providing a genomic dimension to morphologic diagnoses while providing predictive, prognostic, and therapeutic information for patient care. The versatility of cytology specimen preparations provides a variety of options for performing molecular assays, as long as the pre-analytic aspects of specimen processing and handling are optimized and the tests are appropriately validated. With the increasing use of liquid biopsy assays, several investigators are exploring molecular testing using tumor-derived cell-free DNA (cfDNA) in cytology samples. In addition, cytopathologists are discovering ways to better utilize cytology specimens by repurposing previously discarded samples to provide additional genomic information in cases that would otherwise warrant an additional biopsy. These novel applications of molecular assays in cytology have expanded the role of cytopathology in routine patient care. Cytopathologists will need to continue to evolve with the changing landscape of molecular medicine, to adopt and optimize new technology, and to integrate molecular methods into routine cytopathology practice.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Abbreviations
- BRAF :
-
v-Raf murine sarcoma viral oncogene homolog B
- cfDNA:
-
Cell-free DNA
- CSF:
-
Cerebrospinal fluid
- ctDNA:
-
Circulating tumor DNA
- DNA:
-
Deoxyribonucleic acid
- ddPCR:
-
Droplet digital PCR
- EBUS-TBNA:
-
Endobronchial ultrasound-guided transbronchial needle aspiration
- EGFR :
-
Epidermal growth factor receptor
- EUS:
-
Endoscopic ultrasound
- FDA:
-
United States Food and Drug Administration
- FNA:
-
Fine-needle aspiration
- FISH:
-
Fluorescence in situ hybridization
- HPV:
-
Human papillomavirus
- KRAS :
-
Kirsten rat sarcoma viral oncogene homolog
- LBC:
-
Liquid-based cytology
- LOH:
-
Loss of heterozygosity
- NGS:
-
Next-generation sequencing
- NRAS :
-
Neuroblastoma RAS viral oncogene
- PCR:
-
Polymerase chain reaction
- PPAR-γ:
-
Peroxisome proliferator-activated receptor γ
- PTC:
-
Papillary thyroid carcinoma
- RET :
-
Proto-oncogene tyrosine-protein kinase receptor Ret
- RNA:
-
Ribonucleic acid
References
Schmitt FC. Demystifying molecular cytopathology. Int J Surgical Pathol. 2010;18:213S–5S.
Bellevicine C, Malapelle U, Vigliar E, Pisapia P, Vita G, Troncone G. How to prepare cytological samples for molecular testing. J Clin Pathol. 2017;70:819–26.
da Cunha Santos G. Standardizing preanalytical variables for molecular cytopathology. Cancer Cytopathol. 2013;121:341–3.
Maxwell P, Salto-Tellez M. Validation of immunocytochemistry as a morphomolecular technique. Cancer Cytopathol. 2016;124:540–5.
Roy-Chowdhuri S, Stewart J. Preanalytic variables in cytology: lessons learned from next-generation sequencing-the MD Anderson experience. Arch Pathol Lab Med. 2016;140:1191–9.
Fischer AH, Schwartz MR, Moriarty AT, Wilbur DC, Souers R, Fatheree L, et al. Immunohistochemistry practices of cytopathology laboratories: a survey of participants in the College of American Pathologists Nongynecologic Cytopathology Education Program. Arch Pathol Lab Med. 2014;138(9):1167–72.
Berry AB. Analytic inquiry: validation and practical considerations. Cancer. 2017;125:465–9.
Fitzgibbons PL, Bradley LA, Fatheree LA, Alsabeh R, Fulton RS, Goldsmith JD, et al.; College of American Pathologists Pathology and Laboratory Quality Center. Principles of analytic validation of immunohistochemical assays: guideline from the College of American Pathologists Pathology and Laboratory Quality Center. Arch Pathol Lab Med. 2014;138(11):1432–43.
Jennings LJ, Arcila ME, Corless C, Kamel-Reid S, Lubin IM, Pfeifer J, et al. Guidelines for validation of next-generation sequencing-based oncology panels: a joint consensus recommendation of the Association for Molecular Pathology and College of American Pathologists. J Mol Diagn. 2017;19(3):341–65.
Stewart CM, Kothari PD, Mouliere F, Mair R, Somnay S, Benayed R, et al. The value of cell-free DNA for molecular pathology. J Pathol. 2018;244(5):616–27.
Krishnamurthy N, Spencer E, Torkamani A, Nicholson L. Liquid biopsies for cancer: coming to a patient near you. J Clin Med. 2017;6(1):pii: E3.
Kwapisz D. The first liquid biopsy test approved. Is it a new era of mutation testing for non-small cell lung cancer? Ann Transl Med. 2017;5(3):46.
Janku F, Vibat CR, Kosco K, Holley VR, Cabrilo G, Meric-Bernstam F, et al. BRAF V600E mutations in urine and plasma cell-free DNA from patients with Erdheim-Chester disease. Oncotarget. 2014;5(11):3607–10.
Li Y, Pan W, Connolly ID, Reddy S, Nagpal S, Quake S, Gephart MH. Tumor DNA in cerebral spinal fluid reflects clinical course in a patient with melanoma leptomeningeal brain metastases. J Neuro-Oncol. 2016;128(1):93–100.
Li YS, Jiang BY, Yang J, Zhang XC, Zhang Z, Ye JY, et al. Unique genetic profiles from cerebrospinal fluid cell-free DNA in leptomeningeal metastases of EGFR-mutant non-small-cell lung cancer: a new medium of liquid biopsy. Annals Oncol. 2018;29(4):945–52.
Momtaz P, Pentsova E, Abdel-Wahab O, Diamond E, Hyman D, Merghoub T, et al. Quantification of tumor-derived cell free DNA(cfDNA) by digital PCR (DigPCR) in cerebrospinal fluid of patients with BRAFV600 mutated malignancies. Oncotarget. 2016;7(51):85430–6.
Russo IJ, Ju Y, Gordon NS, Zeegers MP, Cheng KK, James ND, et al. Toward personalised liquid biopsies for urothelial carcinoma: characterisation of ddPCR and urinary cfDNA for the detection of the TERT 228 G>A/T mutation. Bladder Cancer. 2018;4(1):41–8.
Togneri FS, Ward DG, Foster JM, Devall AJ, Wojtowicz P, Alyas S, et al. Genomic complexity of urothelial bladder cancer revealed in urinary cfDNA. Eur J Hum Genet. 2016;24(8):1167–74.
Xia Y, Huang CC, Dittmar R, Du M, Wang Y, Liu H, et al. Copy number variations in urine cell free DNA as biomarkers in advanced prostate cancer. Oncotarget. 2016;7(24):35818–31.
Wei S, Lieberman D, Morrissette JJ, Baloch ZW, Roth DB, McGrath C. Using “residual” FNA rinse and body fluid specimens for next-generation sequencing: an institutional experience. Cancer Cytopathol. 2016;124(5):324–9.
Fuller MY, Mody D, Hull A, Pepper K, Hendrickson H, Olsen R. Next-generation sequencing identifies gene mutations that are predictive of malignancy in residual needle rinses collected from fine-needle aspirations of thyroid nodules. Arch Pathol Lab Med. 2018;142(2):178–83.
Doxtader EE, Cheng YW, Zhang Y. Molecular testing of non-small cell lung carcinoma diagnosed by endobronchial ultrasound-guided transbronchial fine-needle aspiration. Arch Pathol Lab Med. 2018. https://doi.org/10.5858/arpa.2017-0184-RA.
Tian SK, Killian JK, Rekhtman N, Benayed R, Middha S, Ladanyi M, et al. Optimizing workflows and processing of cytologic samples for comprehensive analysis by next-generation sequencing: Memorial Sloan Kettering Cancer Center experience. Arch Pathol Lab Med. 2016;140(11):1200–5.
Krane JF, Cibas ES, Alexander EK, Paschke R, Eszlinger M. Molecular analysis of residual ThinPrep material from thyroid FNAs increases diagnostic sensitivity. Cancer Cytopathol. 2015;123(6):356–61.
Kwon H, Kim WG, Eszlinger M, Paschke R, Song DE, Kim M, et al. Molecular diagnosis using residual liquid-based cytology materials for patients with nondiagnostic or indeterminate thyroid nodules. Endocrinol Metab (Seoul). 2016;31(4):586–91.
Deftereos G, Finkelstein SD, Jackson SA, Ellsworth EM, Krishnamurti U, Liu Y, et al. The value of mutational profiling of the cytocentrifugation supernatant fluid from fine-needle aspiration of pancreatic solid mass lesions. Mod Pathol. 2014;27(4):594–601.
Finkelstein SD, Bibbo M, Kowalski TE, Loren DE, Siddiqui AA, Solomides C, Ellsworth E. Mutational analysis of cytocentrifugation supernatant fluid from pancreatic solid mass lesions. Diagn Cytopathol. 2014;42(8):719–25.
Finkelstein SD, Bibbo M, Loren DE, Siddiqui AA, Solomides C, Kowalski TE, Ellsworth E. Molecular analysis of centrifugation supernatant fluid from pancreaticobiliary duct samples can improve cancer detection. Acta Cytol. 2012;56(4):439–47.
Brown AE, Lim KS, Corpus G, Hustek MT, Tran TA, Chang CC. Detection of BRAF mutation in the cytocentrifugation supernatant fluid from fine-needle aspiration of thyroid lesions may enhance the diagnostic yield. Cytojournal. 2017;14:4.
Roy-Chowdhuri S, Mehrotra M, Bolivar AM, Kanagal-Shamanna R, Barkoh BA, Hannigan B, et al. Salvaging the supernatant: next generation cytopathology for solid tumor mutation profiling. Mod Pathol. 2018;31:1036–45.
Malhotra N, Jackson SA, Freed LL, Styn MA, Sidawy MK, Haddad NG, Finkelstein SD. The added value of using mutational profiling in addition to cytology in diagnosing aggressive pancreaticobiliary disease: review of clinical cases at a single center. BMC Gastroenterol. 2014;14(1):135.
da Cunha Santos G, Saieg MA. Preanalytic specimen triage: smears, cell blocks, cytospin preparations, transport media, and cytobanking. Cancer Cytopathol. 2017;125:455–64.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Roy-Chowdhuri, S. (2019). Molecular Cytopathology: Final Thoughts and Future Directions. In: Roy-Chowdhuri, S., VanderLaan, P., Stewart, J., Santos, G. (eds) Molecular Diagnostics in Cytopathology. Springer, Cham. https://doi.org/10.1007/978-3-319-97397-5_20
Download citation
DOI: https://doi.org/10.1007/978-3-319-97397-5_20
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-97396-8
Online ISBN: 978-3-319-97397-5
eBook Packages: MedicineMedicine (R0)