30-Second Takeaway
- Rapid AE1/AE3 IHC on lung frozen sections sharpens STAS calls and speeds intraoperative decisions.
- Panel-adaptable NGS algorithms can quantify MSI with strong concordance to PCR and IHC in small clinical cohorts.
- ccfHPV DNA and ctDNA methylation assays show real promise for recurrence and immunotherapy response monitoring.
- NGS and GPNMB IHC refine classification of clear-cell–like and unusual renal cell tumors.
- EGFR-prediction AI and ctDNA-based CGP require ancestry- and context-aware validation before routine deployment.
Week ending February 14, 2026
Practical updates in molecular and diagnostic pathology: from intraoperative lung STAS calls to AI, liquid biopsy, and immunotherapy monitoring
Rapid AE1/AE3 IHC improves intraoperative STAS assessment in lung adenocarcinoma frozen sections
In 153 lung adenocarcinoma cases, adding rapid AE1/AE3 IHC to frozen H&E increased mean STAS sensitivity from 73.7% to 87.8%. Specificity also improved, from 85.5% to 89.9%, across pathologists with varying experience levels using paraffin sections as reference. Intraobserver agreement rose from κ 0.644 to 0.907, and interobserver agreement from κ 0.485 to 0.671, indicating more reproducible STAS calls. Average diagnostic time actually decreased by about 30 seconds despite adding rapid IHC, without prolonging overall frozen workflow. Misclassification mainly reflected scant STAS clusters, macrophage mimics, and artefact, underscoring the interpretive challenge even with IHC.
Adaptable NGS pipeline yields quantitative MSI status with high concordance to PCR and IHC
An NGS-based, Python-implemented pipeline quantified microsatellite mutational burden using a custom cancer panel in 32 diverse tumors. NGS-derived microsatellite status showed 100% concordance with PCR and 90.32% concordance with MMR IHC results. The framework provides a transparent, panel-agnostic approach that can be adapted to existing clinical sequencing assays. This proof-of-concept supports integrating MSI calling into routine NGS rather than performing standalone PCR in many settings.
Ultrasensitive NGS detection of circulating HPV DNA predicts cervical cancer recurrence months before imaging
In 141 cervical cancer patients across FIGO stages IA1–IVB, NGS-based circulating HPV DNA (ccfHPV) was measured longitudinally. Pretreatment ccfHPV DNA positivity was associated with higher recurrence risk (adjusted HR 4.92; 95% CI 1.29–18.7). Positivity at the first post-treatment sample strongly predicted recurrence (adjusted HR 19.1; 95% CI 7.27–50.2). At early follow-up, the assay’s PPV for recurrence within 50 months was 83% and NPV was 90%. Among patients who recurred, ccfHPV DNA became detectable before clinical evidence in 60.9% with a mean 144-day lead time.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.