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A proposal for cellularity assessment for EGFR mutational analysis with a correlation with DNA yield and evaluation of the number of sections obtained from cell blocks for immunohistochemistry in non-small cell lung carcinoma
  1. Gilda da Cunha Santos1,2,
  2. Tyler Wyeth2,
  3. Allie Reid2,
  4. Mauro Ajaj Saieg3,
  5. Bethany Pitcher4,
  6. Melania Pintilie4,
  7. Suzanne Kamel-Reid1,2,
  8. Ming Sound Tsao1,2
  1. 1Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
  2. 2Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
  3. 3Department of Pathology, Santa Casa Medical School, São Paulo, Brazil
  4. 4Department of Biostatistics, University Health Network and Princess Margaret Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Gilda da Cunha Santos, Department of Laboratory Medicine and Pathobiology, University of Toronto, University Health Network, 200 Elizabeth Street, 11th Floor, Eaton Wing, Toronto, Ontario, Canada M5G 2C4; gilda.santos{at}


Aims Different approaches have been described for reporting specimen adequacy for epidermal growth factor receptor (EGFR) mutation analysis. We aimed: (1) to conduct cellularity assessment and to investigate its association with DNA yield, (2) to compare the H&E slides taken before and after the thick sections (curls) obtained for EGFR testing and (3) to evaluate the number of ancillary studies performed.

Methods Cell block (CB) slides of 110 non-small cell lung carcinoma cases submitted to EGFR analysis from 2010 to 2012 were reviewed for total cellularity (ranges 1–100, 100–250, 250–500, 500–750, 750–1000 and >1000 cells), tumour cellularity (ranges 1–50, 50–100, 100–300 and >300 cells) and the percentage of tumour cells. Precurl and postcurl H&E slides were compared using the three criteria. The number of immunohistochemistry (IHC) markers and special stains and DNA yield were recorded.

Results DNA yield was significantly associated with the total cellularity, number and percentage of tumour cells. For 46 cases with precurl and postcurl slides, only three (6.5%) were classified as being different and in two of them the postcurl slide had greater cellularity than the precurl. IHC was performed in 83 cases, with a minimum of 1 and a maximum of 11 markers (median of 3) per case.

Conclusions An association between the total cellularity and the tumour cellularity with the DNA yield was demonstrated using the ranges described. Evaluation of a postcurl slide is an unnecessary practice. The majority of the CB had sufficient material for ancillary studies (up to 11 markers) and mutation testing.

  • EGFR

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