Accessing utility of immunohistochemistry, PD-L1 correlation with stage of cancer and EGFR mutation with disease survival in primary lung carcinoma
Abstract Background Accurate non-small cell lung carcinoma (NSCLC) typing is crucial for targeted therapy selection. This study investigates how immunohistochemistry (IHC) can improve early diagnosis and molecular categorization of NSCLC. Additionally, we explore the relationship between epidermal g...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-06-01
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| Series: | Surgical and Experimental Pathology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42047-025-00190-8 |
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| Summary: | Abstract Background Accurate non-small cell lung carcinoma (NSCLC) typing is crucial for targeted therapy selection. This study investigates how immunohistochemistry (IHC) can improve early diagnosis and molecular categorization of NSCLC. Additionally, we explore the relationship between epidermal growth factor receptor (EGFR) expression and patient overall survival (OS), as well as the correlation between programmed death ligand 1 (PD-L1) expression and cancer staging. Method This prospective cross-sectional study analyzed histopathology samples from more than 18 year-old patients diagnosed with primary lung carcinoma at AIIMS Raipur between 2019 and 2020. The study evaluated diagnostic and prognostic IHC markers, using descriptive statistics (frequencies and percentages) to summarize the data. T-staging and clinical staging followed american joint committee on cancer staging guidelines. A one-year follow-up was conducted. Sensitivity, specificity, and diagnostic accuracy were calculated, with significance assessed using Chi-square and Fisher’s exact tests. Result Among 44 NSCLC cases only 4 could clearly be subclassified without IHC. Two IHC markers, one for each subtype, were sufficient for typing of NSCLC in most cases (above 50%). TTF1 showed a sensitivity of 75% and specificity of 81.8% for adenocarcinoma. P63 exhibited a sensitivity of 66.67%, suggesting slightly lower detection capability, but excelled in specificity with 96.4% for squamous cell carcinoma. Overall, 40.91% cases were positive for EGFR and 45.45% for PD-L1 on IHC in cases studied. We found no significant association between the stage of primary lung carcinoma and PD-L1 expression (p = 0.376, df = 1 and χ2 = 0.782). EGFR expression is associated with better OS (P = 0.0005, df = 1 and χ2 = 12.063). Additionally, morphological correlation was also found significant with EGFR expression (p = 0.009, df = 2 and χ2 = 9.37). No statistically significant association between the subtypes of ADC and PD-L1 positivity (p = 0.98, df = 2 and χ2 = 0.026). Conclusion IHC is crucial for subtyping lung carcinoma in small biopsies. When morphology is insufficient, identifying at least one marker per subtype aids in diagnosis. PD-L1 positivity has no correlation with advanced cancer stages, while EGFR positivity is associated with improved OS. |
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| ISSN: | 2520-8454 |