Molecular characterization of lung carcinomas: A study on diagnostic, predictive, and prognostic markers using immunohistochemical analysis at a tertiary care center in Uttarakhand, India

Abstract

INTRODUCTION: Focused studies in different geographic regions would delineate the underlying biological differences and molecular alterations in non-small cell lung cancer (NSCLC) worldwide. Previous studies in literature have documented limited characterization by studying a minimal number of biological markers. This study was done to evaluate expression of multiple immunomarkers including diagnostic, prognostic, and predictive markers in NSCLC for its characterization. MATERIALS AND METHODS: This was an observational study conducted on 60 consecutive cases of NSCLC. Immunomarkers comprising of p63, p40, TTF-1, napsin A, B-Raf, c-Met, phospho-AKT (P-AKT), PTEN, anaplastic lymphoma kinase (ALK), epidermal growth factor receptor (EGFR) and K-Ras, synaptophysin, chromogranin and pan-cytokeratin were evaluated on paraffin-embedded tissue sections of NSCLC. RESULTS: Age of patients with NSCLC in our study ranged from 35 to 90 years, and 93.3% of them were chronic smokers. 93.3% of cases presented in late stages (Stages III and IV) and 78% of cases were squamous cell carcinoma (SCC). EGFR positivity was noted in 83.3% of cases. ALK was positive in one case while C-Met and PTEN immunopositivity was noted in only two cases. Ten cases showed positivity for K-Ras and 90% of these were SCC. Ten cases were positive for B-Raf and 80% of these were SCC. 30% of cases showed immunopositivity for P-AKT. None of the molecular markers was found to have statistically significant correlation with clinicopathological parameters. CONCLUSION: SCC is the predominant histological subtype of NSCLC in the region of Uttarakhand, India, with a high proportion of cases harboring EGFR mutation. Variable expression of K-Ras, P-AKT, ALK 1, and PTEN in NSCLC signifies that molecular profile of every case is individualistic and independent. We attribute this to ethnicity, influence of implicated substance or metabolite in tobacco, and variable mutations incurred in tumor cells over a period of time.

Landscapes of synchronous multiple primary cancers detected by next‐generation sequencing

“…In addition to the definition of mutation sites in the synchronous multiple primary samples, we also classified mutated genes with various diseases, BPs, and MFs through cluster analysis. Notably, mutations in ALK and PTEN are concordant in a range of tumor types, including lung adenocarcinoma, endometrial cancer, colorectal cancer, and triple‐negative breast cancer [ 15 , 16 , 17 , 18 , 19 ]. Previously, a study examining clinically relevant mutations in 91 different malignancies also found mutation sites in anaplastic lymphoma kinase (ALK) and PTEN [ 20 ].…”

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“…People often visit dentists when they are suffering from an illness [1,2]. Indonesia Health Data Profile 2010 revealed that pulp and periapical diseases are found in the 7 th of the ten most common diseases of outpatients in Indonesian Hospitals [3][4][5][6]. According to the Health Profile of Surakarta in 2014, the prevalence of pulp abnormalities and periapical tissue was 16,186 cases (2,56%) from the data of outpatient disease patterns in Surakarta Community Health Centre [4][5][6][7][8][9].…”

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“…Dental and oral disease is an essential issue of the health sector in general; however, in developing countries, there is a tendency to increase dental and oral diseases, one of which is dental caries, which, if untreated, can lead to tooth necrosis [1][2][3][4][5][6][7][8][9][10]. Treatment of tooth decay, such as caries or pulp necrosis, necessitates crown restoration and the creation of a post [11].…”