ABSTRACT
Background: Histology and genetically driven management are the current standard in carcinoma lung. Adequate tissue is a challenge in a few cases. While liquid biopsy is an, it’s an always preferred to get an initial cyto/histo morphological confirmation. While the immune-histo chemistry (IHC) is a proven method to differentiate the squamous vs adeno carcinoma, the role of various “immuno-cyto-chemical” makers were not studied widely. Methods: This is a retrospective (July 2018 to December 2018) for random sample collection and prospective (Jan 2019-August 2019) study conducted from in the Department of pathology, govt. chest hospital Osmania medical college, Hyderabad as a part of PG dissertation, 120 subjects with cytological diagnosis of non-small cell lung carcinoma were analyzed during this period and others were excluded. Results: Out of 120 cases 80-adenocarcinoma (ADC) and 40-squamous cell carcinoma (SCC). Most of the patients are in 61-70 years, 20 are 71-80 years, 20 between 51-60 and 10 are between 40-50 years. In this study sensitivity of p63 and p40 is equal, but specificity and positive predictive value are higher for p40 for diagnosis of SCC. Conclusions: Immuno-cyto-chemistry is still a valid option in selected cases where getting a biopsy is difficult. Our findings recommend the use of p40 immuno staining rather than p63 as a squamous cell marker.
ABSTRACT
Background: Aim of the study was to evaluate the spectrum of genetic variations in young cancer patients presenting to the tertiary cancer center Methods: All newly diagnosed patients with cancer presenting to medical oncology OPD at continental hospitals between November 2021 till July 2023 were analyzed. Multigene panel testing (56 genes) by next-generation sequencing was performed for all patients. Demographics and clinical characters were represented using descriptive statistics. The Chi-square test was used to compare the cohorts of Mutations vs. non mutations. Results: A total of 130 cancer patients were screened and 70 were recruited in the study, which had complete set of clinical details available. Median age of Cohort is 41.9±6.6 years and for females it is 43.6±6.8 years and males it is 40.5±7.3, with males presenting at approximately 3 years earlier than females (p=0.12), which is not statistically significant. Male female ratio is 1.2:1, which is much less compared to Globocon statistics of cancer in India. A total of 47% (33/70) subjects had some mutation and approximately 16% (11/70) had variance of unknown significance and 32% (22/70) patients had pathogenic variants. The commonest cancer is breast followed by colon and prostate. Conclusions: Younger cancer patients presenting with atypical symptoms harbor more frequent germ line mutations, than expected. In view of the low cost, standardized and wide availability of the germ line analysis, it’s preferred to offer the test, wherever clinically relevant. This can help for better education, screening and early intervention, that ultimately help improve the cancer statistics in healthier directions.