Neuroanatomical location of lung cancer brain metastases in 234 patients with a focus on cancer subtyping and biomarkers.

Brain metastases are frequent in neuropathology practices; however, the literature on their distribution is frequently derived from imaging studies. This work examined metastases of lung cancer to the brain through the lens of pathology specimens. All brain surgical pathology cases accessioned from...

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Main Authors: Michael Bonert, Jens Schittenhelm, Housne Begum, Jian-Qiang Lu, Anand Swaminath, Rosalyn A Juergens, Alison Berzins, Jean-Claude Cutz, Asghar H Naqvi
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0314205
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author Michael Bonert
Jens Schittenhelm
Housne Begum
Jian-Qiang Lu
Anand Swaminath
Rosalyn A Juergens
Alison Berzins
Jean-Claude Cutz
Asghar H Naqvi
author_facet Michael Bonert
Jens Schittenhelm
Housne Begum
Jian-Qiang Lu
Anand Swaminath
Rosalyn A Juergens
Alison Berzins
Jean-Claude Cutz
Asghar H Naqvi
author_sort Michael Bonert
collection DOAJ
description Brain metastases are frequent in neuropathology practices; however, the literature on their distribution is frequently derived from imaging studies. This work examined metastases of lung cancer to the brain through the lens of pathology specimens. All brain surgical pathology cases accessioned from 2011-2020 were retrieved from a regional laboratory. Specimens were classified by neuroanatomical location, diagnostic category, and diagnosis with a hierarchical free text string-matching algorithm. All reports classified as probable metastasis per algorithm were reviewed by a pathologist. Lung biomarkers and selected immunostains were retrieved with text parsing and reviewed. Among 4,625 cases of brain surgical resection specimens, 854 were classified as probable metastasis by the algorithm. On report review, 538/854 cases were confirmed as metastasis with a known primary site. The 538 cases were from 511 patients and 234/511 patients had lung primaries. Small cell lung cancer lesions were most frequently found in the cerebellum (17/30). Lesions from lung adenocarcinoma (59/164) and non-small cell carcinoma-not otherwise specified (NSCLC-NOS) (15/34) were most commonly found in the frontal lobe. Squamous cell carcinoma lesions were most commonly found in the frontal and occipital lobes (8/27). 72/234 cases were reported as NSCLC-NOS and could be further subclassified using immunostaining (41/72). Lung biomarker data were retrieved in ~38% of cases. PD-L1 positivity was dependent on neuroanatomical distribution (p = 0.04); other examined biomarkers were not. The distribution of lung tumours metastatic to the brain is dependent on the lung cancer subtype (p<0.001). The reporting of histologic subtype could be further optimized in the local environment.
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spelling doaj-art-571b5ce1b48f40a1be3150f13a5a680f2025-08-20T02:33:07ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011911e031420510.1371/journal.pone.0314205Neuroanatomical location of lung cancer brain metastases in 234 patients with a focus on cancer subtyping and biomarkers.Michael BonertJens SchittenhelmHousne BegumJian-Qiang LuAnand SwaminathRosalyn A JuergensAlison BerzinsJean-Claude CutzAsghar H NaqviBrain metastases are frequent in neuropathology practices; however, the literature on their distribution is frequently derived from imaging studies. This work examined metastases of lung cancer to the brain through the lens of pathology specimens. All brain surgical pathology cases accessioned from 2011-2020 were retrieved from a regional laboratory. Specimens were classified by neuroanatomical location, diagnostic category, and diagnosis with a hierarchical free text string-matching algorithm. All reports classified as probable metastasis per algorithm were reviewed by a pathologist. Lung biomarkers and selected immunostains were retrieved with text parsing and reviewed. Among 4,625 cases of brain surgical resection specimens, 854 were classified as probable metastasis by the algorithm. On report review, 538/854 cases were confirmed as metastasis with a known primary site. The 538 cases were from 511 patients and 234/511 patients had lung primaries. Small cell lung cancer lesions were most frequently found in the cerebellum (17/30). Lesions from lung adenocarcinoma (59/164) and non-small cell carcinoma-not otherwise specified (NSCLC-NOS) (15/34) were most commonly found in the frontal lobe. Squamous cell carcinoma lesions were most commonly found in the frontal and occipital lobes (8/27). 72/234 cases were reported as NSCLC-NOS and could be further subclassified using immunostaining (41/72). Lung biomarker data were retrieved in ~38% of cases. PD-L1 positivity was dependent on neuroanatomical distribution (p = 0.04); other examined biomarkers were not. The distribution of lung tumours metastatic to the brain is dependent on the lung cancer subtype (p<0.001). The reporting of histologic subtype could be further optimized in the local environment.https://doi.org/10.1371/journal.pone.0314205
spellingShingle Michael Bonert
Jens Schittenhelm
Housne Begum
Jian-Qiang Lu
Anand Swaminath
Rosalyn A Juergens
Alison Berzins
Jean-Claude Cutz
Asghar H Naqvi
Neuroanatomical location of lung cancer brain metastases in 234 patients with a focus on cancer subtyping and biomarkers.
PLoS ONE
title Neuroanatomical location of lung cancer brain metastases in 234 patients with a focus on cancer subtyping and biomarkers.
title_full Neuroanatomical location of lung cancer brain metastases in 234 patients with a focus on cancer subtyping and biomarkers.
title_fullStr Neuroanatomical location of lung cancer brain metastases in 234 patients with a focus on cancer subtyping and biomarkers.
title_full_unstemmed Neuroanatomical location of lung cancer brain metastases in 234 patients with a focus on cancer subtyping and biomarkers.
title_short Neuroanatomical location of lung cancer brain metastases in 234 patients with a focus on cancer subtyping and biomarkers.
title_sort neuroanatomical location of lung cancer brain metastases in 234 patients with a focus on cancer subtyping and biomarkers
url https://doi.org/10.1371/journal.pone.0314205
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