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Lung Carcinoma Molecular Analysis

Reference Number: AA-00314




Lung Carcinoma Molecular Analysis

Clinical Significance:

Recently established guidelines from the American Society for Clinical Pathology (ASCP), College of American Pathologists (CAP), Association for Molecular Pathology (AMP), and/or the American Society of Clinical Oncology (ASCP) recommend testing for all newly diagnosed non-small cell, non-squamous lung carcinomas or such metastatic lung carcinomas that have not had a primary resection available for testing:

  •         EGFR, common variants (e.g., exon 19 LREA deletion, L858R, T790M, E709A, G719X, L861Q) [note: includes exon 20 insertion]
  •         BRAF V600E variant
  •         ALK 2p23 gene rearrangement
  •         ROS1 6q22 gene rearrangement
  •         RET 10q11 gene rearrangement
  •         cMET 7q31 amplification
  •         cMET Exon 14 skipping mutation gene analysis
  •         HER2 (ERBB2)  gene mutation analysis (Exon 20)
  •         PD-L1 immunohistochemistry, quantitative analysis on all non-small cell lung carcinomas (including squamous cell carcinomas)
  •         NTRK gene rearrangement by immunohistochemistry, quantitative analysis with reflex of positive cases to confirmatory RNA-based NGS analysis.

https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf

 

Specimen Requirements and Collection:

Formalin-fixed tissue containing a sufficient amount of tumor (generally at least several mm of tumor tissue submitted in the tissue block)


Methodology:

DNA isolation and extraction, library prep, fluorescent in-situ hybridization (FISH), immunohistochemistry (IHC), and next-generation sequencing (NGS)


Forms:

Molecular pathology requisition form


Transport:

Send formalin-fixed, paraffin-embedded (FFPE) tissue and cell block containing tumor at room temperature.  Also acceptable 10-unstained, 4-5 micron slides with 1 post H&E.  Please include a surgical pathology report


Unacceptable specimen:

Specimens fixed in alternative fixatives or metal fixatives (ex. B-plus).  Decalcified specimens.


CPT Codes

88381, 81210, 81235, 81403x2, 88360x2, 88377x4


Test reported:

Results are reported within 7-10 days