HISTOLOGICAL VARIANTS OF LUNG CARCINOMA AND THEIR CLINICAL CORRELATES: A PULMONOLOGY-PATHOLOGY INTEGRATION

Abstract

Proper histological subtyping of lung cancer is required in prognosis, biomarker evaluation and treatment choice, particularly when tiny biopsies and cytological information are used to base the diagnosis.  An analytic methodology of quantitative, retrospective observations evaluated patients with pathologically confirmed primary lung cancer that were adult.  Getting clinical, radiology, sampling and pathological features into the pulmonology-pathology workflow.  We applied histomorphology and in cases where necessary immunohistochemistry (IHC) to subtype them. Then we employed bivariate testing and multivariate regression to examine the relationship between these subtypes and clinical correlates. The most prevalent type of cancer was adenocarcinoma that constituted 55.1 percent of the cases. The next were squamous cell carcinoma which comprised 22.1% of the cases. Small cell lung carcinoma constituted 17.9% of the cases and other/rare NSCLC constituted 4.8% cases.  Scientifically, SCC had a greater smoking background (88.4) and a more notable central tumor (73.9) compared to adenocarcinoma (73.3 and 27.3, respectively).  The images showed correlations that showed a greater prevalence of cavitation in SCC (24.6) than in adenocarcinoma (9.9).  IHC profiles were fairly effective in distinguishing the various types. As an illustration, TTF-1 and Napsin A were more prevalent in adenocarcinoma (77.9% and 73.3%), in contrast to p40 and p63, which were more prevalent in SCC (85.5% and 81.2%). SCLC was positive in synaptophysin (92.9%), chromogranin (78.6%), and Ki-67 (87.5%).  The stage of the case was advanced, and stage IV constituted the greatest prevalence of SCLC (66.1%).  When the multivariate model (SCC vs adenocarcinoma) was adopted, p40 positivity (adjusted OR 9.50), smoking (adjusted OR 2.90) and central position (adjusted OR 2.20) were independent predictors in favour of SCC whereas TTF-1 positivity was in favour of adenocarcinoma (adjusted OR 0.10).  By integrating the data about pulmonology sampling with the pathology-grounded histomorphology and a specific panel of IHC, it is feasible to do a correct subtyping of lung cancer, as well as to identify a range of clinically relevant associations that are relevant to staging and further biomarker-based therapy approaches.