A Study of the Clinical, Pathological and Radiological Profile of Lung Cancer in Non-Smokers

ABSTRACT

Aim and Objective: To study the clinical, pathological andradiological profile of lung cancer in non-smokers in a tertiarycare center.Methods: 53 non-smokers diagnosed with lung cancerattending the Department of Respiratory Medicine, KingGeorge’s Medical College from September 2015 to August2017 were enrolled. Record of all diagnostic investigations andprocedures performed namely transthoracic fine needleaspiration cytology (FNAC) and biopsy, bronchoscopy,thoracoscopy, closed pleural biopsy, lymph-node FNAC andbiopsy, routine blood and sputum examinations and a detailedhistory were obtained. Data was analysed retrospectively.Results: The mean age of presentation was 53.8±11.6 years.Majority were females (60.4%). Most common presentingsymptom was cough (84.9%). Mean duration of symptoms was6.9 months. Pallor was the most common clinical examinationfinding (41.5%). Mass with effusion was the most commonradiological lesion (45.3%). 22.6% masses were centrallylocated. Transthoracic biopsy could diagnose 32 (60.4%)cases. Adenocarcinoma was the most common type in bothmales (76.2%) and females (78.1%). Epidermal growth factorreceptor (EGFR) mutation was positive in 46.3% ofadenocarcinoma. Exon 19 deletion was the more commonmutation.Conclusion: Lung cancer among never smokers is a distinctclass with risk factors and genetic features discrete from thoseassociated with tobacco smoke. Indoor air pollutants as well asETS are definitely implicated risk factors. Targetable mutationsare commoner in non-smokers and hence mutation testingshould always be done in such patients. It is important toconduct studies about the diverse characteristics of this entityto consolidate our knowledge of this growing group of cancer.