An Observational Study of Clinical and Pathological Profile of Patients with Metastatic Nonsmall Cell Lung Carcinoma in a Tertiary Care Hospital, India

A BSTRACT Objectives: The objectives of this study were to describe the clinical, pathological, and molecular profile of metastatic nonsmall cell lung carcinoma patients. Methods: An observational cross-sectional study was done on 70 patients of lung cancer. Patients’ characteristics noted were age, gender, history of lung disease, comorbidities, clinical features, affected lobe, and metastasis. Histopathological examination was done. Immunohistochemistry (IHC) and molecular profiles were tested for cytokeratin 7 (CK7), thyroid transcription factor-1 (TTF-1), NAPSIN, epidermal growth factor receptor (EGFR) 19-21, ROS1, anaplastic lymphoma kinase (ALK), BRAF, TP53, KRAS, MET, and programmed death ligand-1 (PDL-1), respectively. Results: Patients profile showed that the mean age was 58 ± 13.68 years, with 44 (62.85%) males. Symptoms included cough (45.71%), weight loss (27.14%), and dyspnea (15.71%). The most common site involved was the right upper lobe lung (31.43%). In terms of metastasis, site involved was lymph nodes (59%) and bone (43%). Histopathology showed that 93% had adenocarcinoma and 7% had squamous cell carcinoma. IHC revealed TTF-1 positivity in 24.29% of cases, CK7 positivity in 12.86% of cases, and NAPSIN positivity in 10% of cases. Molecular profiling showed EGFR-19 positivity in 15.71% of cases, ALK positivity in 12.86% of cases, PDL-1 positivity in 10% of cases, and TP53 positivity in 8.57% of cases. Conclusion: Lung cancer mainly presents in the elderly age group of 61–70 years, with male predominance. Common symptoms include cough, weight loss, and dyspnea. Histopathologically, adenocarcinoma was the most common subtype. The common mutations identified were EGFR (exons 19, 20, and 21), ALK, and TP53. TTF-1 and CK7 hold a significant association in terms of IHC positivity.