EGFR mutational status of primary Lung Adenocarcinoma in an Indian cohort based on 2015 WHO classification of lung tumors.

  • Priyanka Yogendra Ravi Department of Pathology, Christian Medical College, Vellore, India.
  • Anila Korula Department of Pathology, Christian Medical College, Vellore, India.
  • Visalakshi Jeyaseelan Department of Biostatistics, Christian Medical College, Vellore, India
  • Dhananjayan Sakthi Department of General Pathology, Christian Medical College, Vellore, India.
  • Rekha Pai Department of General Pathology, Christian Medical College, Vellore, India
Keywords: EGFR mutation, Lung cancer, Histology, Adenocarcinoma, WHO classification, India.

Abstract

Background: Epidermal growth factor receptor (EGFR) mutations have been known to be associated with adenocarcinoma, women, non- smokers and East-Asian ethnicity. This study was aimed to characterize the frequency of EGFR mutations and their association with histologic subtypes in primary lung adenocarcinoma in an Indian cohort.Methods: Two seventy-four cases were categorized using 2015 WHO classification of lung tumors. The frequency of each histologic subtype and cell type was correlated with EGFR exon sequences in a subset of 120 cases using polymerase chain reaction (PCR) gene sequencing.Results: The predominant biopsy categories in 274 cases were acinar 167(61%), solid 63(23%), mucinous 19(7%), lepidic 11(4%) and others 14(5%). EGFR mutations were detected in 49/120 (40.8%) including 3/5(60%) lepidic, 4/9(44.4%) papillary, 29/68(42.7%) acinar, 10/24(41.7%) solid and 1/13(7.7%) mucinous subtypes and were significantly associated with the cuboidal cell type (p=0.01). These mutations were common in women and non-smokers, although not statistically significant. Exon 19 mutations predominated in 36/49(73.4%).  The majority, 213/263 (81%), were thyroid transcription factor 1(TTF-1) positive. The polygonal cell type and the solid subtype were frequent amongst stage IV tumors and smokers.Conclusions: EGFR mutations were most frequently seen with the lepidic and papillary subtypes, not associated with the mucinous subtype, more common in women and non-smokers and significantly associated with the cuboidal cell type. DOI: 10.21276/APALM.1372

Author Biographies

Priyanka Yogendra Ravi, Department of Pathology, Christian Medical College, Vellore, India.
Ex-Postgraduate, Christian Medical College, Vellore, India
Anila Korula, Department of Pathology, Christian Medical College, Vellore, India.
Professor, Department of General Pathology
Visalakshi Jeyaseelan, Department of Biostatistics, Christian Medical College, Vellore, India
Lecturer, Department of Biostatistics, Christian Medical College, Vellore, India
Dhananjayan Sakthi, Department of General Pathology, Christian Medical College, Vellore, India.
Senior demonstrator, Department of General Pathology, Christian Medical College, Vellore, India.
Rekha Pai, Department of General Pathology, Christian Medical College, Vellore, India
Associate professor, Department of General Pathology, Christian Medical College, Vellore, India

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Published
2017-10-25
Section
Original Article