The New IASLC/ATS/ERS Classification with Clinicopathological Features of Primary Lung Adenocarcinomas and Correlation with EGFR Mutational Status

Ravi Priyanka, Yogendra (2015) The New IASLC/ATS/ERS Classification with Clinicopathological Features of Primary Lung Adenocarcinomas and Correlation with EGFR Mutational Status. Masters thesis, Christian Medical College, Vellore.


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AIM OF THE STUDY: To do a detailed histopathological study of all Primary Lung Adenocarcinomas using the New IASLC/ATS/ERS classification, biopsied in our institution from June 2011- December 2012 and correlate this data with EGFR mutational status. OBJECTIVES: 1. To categorize and study the detailed histopathological features of all Primary Lung Adenocarcinomas using the 2011 New International Classification (IASLC/ATS/ERS) classification for lung adenocarcinomas. 2. To correlate these histopathological features with data available on EGFR mutational status performed by PCR Sequencing. 3. To further sub-classify these adenocarcinomas that is predominantly associated with EGFR mutations. 4. To correlate the above with parameters such as gender, age, smoking, status and stage of disease. CLINICAL AND STATISTICAL METHODS: Two hundred and seventy four cases were categorized using the IASLC/ETS/ARS classification and correlated with EGFR exon sequences performed in a subset of 120 cases using PCR Sequencing. TTF-1 immunohistochemistry was performed in majority of cases. Demographic details including age, gender, smoking status and geographical location were obtained from the electronic computerized medical records. Radiological findings were obtained from the CT scan results from the Picture Archiving and Communication System. Data was analyzed using the SPSS software. Descriptive statistics for continuous data were analyzed using mean with Standard deviation or median with inter-quartile range. Categorical data was described using frequencies and percentages. Histopathological subtypes, cell type and clinico-pathological features with EGFR mutational analysis were associated using Fischer's exact test and Chi square test. RESULTS: The predominant biopsy categories of adenocarcinoma were, invasive acinar (61%), solid with mucin production (23%), mucinous (19%) and lepidic (4%). EGFR mutations were detected in 40.9% cases, mainly with lepidic (60%), papillary (44.4%), acinar (42.7%) and solid variants (41.7%) and cuboidal cell type (P=0.013) and infrequent with mucinous subtype (P=0.015).The commonest form of mutation involved exon 19 in 69.4% cases. Majority were TTF-1 positive (81%, P=0.007), mainly associated with lepidic and papillary subtypes. The polygonal cell type was frequently noted among grade III tumours, in stage IV and smokers. The solid variant was relatively frequent in smokers and was poorly differentiated. Thus, in this study we conclude that the New IASLC/ATS/ERS classification confirms the positive statistical association of the predominant subtype of invasive adenocarcinoma and the cell type with EGFR mutations and TTF-1 reactivity.

Item Type: Thesis (Masters)
Uncontrolled Keywords: New IASLC/ATS/ERS classification ; Adenocarcinoma ; Lung ; Epidermal growth factor receptor ; TTF-1.
Subjects: MEDICAL > Pathology
Depositing User: Punitha K
Date Deposited: 19 May 2018 15:16
Last Modified: 22 May 2018 18:30

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