Study of p40 is superior to p63 for the diagnosis of pulmonary squamous cell carcinoma on cytological smears

Authors

  • S. Nageshwar Rao Department of Pathology, Bhaskar Medical College, Hyderabad, Telangana, India
  • Anuradha Vutukuru Department of Pathology, Bhaskar Medical College, Hyderabad, Telangana, India
  • K. Durga Department of Pathology, Narayana Medical College, Nellore, Andhra Pradesh, India
  • K. B. Mithila Department of Pathology, Bhaskar Medical College, Hyderabad, Telangana, India
  • Sailaja V. Department of Pathology, Bhaskar Medical College, Hyderabad, Telangana, India
  • Vijay Sreedhar Department of Pathology, Bhaskar Medical College, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20240679

Keywords:

ADC, Immunostaining, Squamous cell marker, Carcinoma lung

Abstract

Background: Histology and genetically driven management are the current standard in carcinoma lung. Adequate tissue is a challenge in a few cases. While liquid biopsy is an, it’s an always preferred to get an initial cyto/histo morphological confirmation. While the immune-histo chemistry (IHC) is a proven method to differentiate the squamous vs adeno carcinoma, the role of various “immuno-cyto-chemical” makers were not studied widely.

Methods: This is a retrospective (July 2018 to December 2018) for random sample collection and prospective (Jan 2019-August 2019) study conducted from in the Department of pathology, govt. chest hospital Osmania medical college, Hyderabad as a part of PG dissertation, 120 subjects with cytological diagnosis of non-small cell lung carcinoma were analyzed during this period and others were excluded.

Results: Out of 120 cases 80-adenocarcinoma (ADC) and 40-squamous cell carcinoma (SCC). Most of the patients are in 61-70 years, 20 are 71-80 years, 20 between 51-60 and 10 are between 40-50 years. In this study sensitivity of p63 and p40 is equal, but specificity and positive predictive value are higher for p40 for diagnosis of SCC.

Conclusions: Immuno-cyto-chemistry is still a valid option in selected cases where getting a biopsy is difficult. Our findings recommend the use of p40 immuno staining rather than p63 as a squamous cell marker.

References

Shankar S, Thanasekaran V, Dhanasekar T, Duvooru P. Clinicopathological and immunohistochemical profile of non-small cell lung carcinoma in a tertiary care medical centre in South India. Lung India. 2014;31(1):23-8.

Rawat J, Sindhwani G, Gaur D, Dua R, Saini S. Clinico-pathological profile of lung cancer in Uttarakhand. Lung India. 2009;26(3):74-6.

Noronha V, Dikshit R, Raut N, Joshi A, Pramesh CS, George K, et al. Epidemiology of lung cancer in India: focus on the differences between non-smokers and smokers: a single-centre experience. Indian J Cancer. 2012;49(1):74-81.

Deo SVS, Sharma J, Kumar S. GLOBOCAN 2020 Report on Global Cancer Burden: Challenges and Opportunities for Surgical Oncologists. Ann Surg Oncol. 2022;29(11):6497-500.

American-Cancer-Society. Cancer facts and figures 2014. Atlanta: Am Cancer Society; 2014.

Travis WD, Brambilla E, Riely GJ. New pathologic classification of lung cancer: Relevance for clinical practice and clinical trials. J Clin Oncol. 2013;31(8):992-1001.

Malik PS, Sharma MC, Mohanti BK, Shukla NK, Deo S, Mohan A, et al. Clinico-pathological profile of lung cancer at AIIMS: a changing paradigm in India. Asian Pac J Cancer Prev. 2013;14(1):489-94.

Kumar BS, Abhijit M, Debasis D, Abinash A, Ghoshal AG, Kumar DS. Clinico pathological profile of lung cancer in a tertiary medical centre in India: Analysis of 266 cases. J Dent Oral Hyg. 2011;3(3):30-3.

Gajalakshmi V, Hung RJ, Mathew A, Varghese C, Brennan P, Boffetta P. Tobacco smoking and chewing, alcohol drinking and lung cancer risk among men in southern India. Int J Cancer. 2003;107(3):441-7.

Kadara H, Kabbout M, Wistuba II. Pulmonary adenocarcinoma: a renewed entity in 2011. Respirology. 2012;17(1):50-65.

Witschi H. A short history of lung cancer. Toxicological Sci. 2021;64(1):4-6.

Pass HI, Carbone DP, Johnson DH, Minna JD. Principles and practice of lung cancer: The official reference text of the IASLC. Wolters Kluwer: Lippincott Williams and Wilkins; 2010.

Feldman AT, Wolfe D. Tissue processes and hematoxylin and eosin staining. Methods Mol Biol. 2014;1180:31-43.

Lemjabbar-Alaoui H, Hassan OU, Yang YW, Buchanan P. Lung cancer: Biology and treatment options. Biochim Biophys Acta. 2015;1856(2):189-210.

Gijtenbeek RG, De Jong K, Venmans BJ, Van Vollenhoven FH, Ten Brinke A, Van der Wekken AJ, et al. Best first-line therapy for people with advanced non-small cell lung cancer, performance status 2 without a targetable mutation or with an unknown mutation status. Cochrane Database Syst Rev. 2023;7(7):CD013382.

Zhang Y, Shi L, Simoff MJ, J Wagner O, Lavin J. Biopsy frequency and complications among lung cancer patients in the United States. Lung Cancer Manag. 2020;9(4):LMT40.

Prashant, Ramachandra C, Pattbhiraman, Raghuram, Attili VSS. Feasibility, safety, and efficacy of the CT guided fine needle aspiration cytology (FNAC) of lung, lesions. Indian J Med Paediatr Oncol. 2007;28(2):16-25.

Inamura K. Update on Immunohistochemistry for the Diagnosis of Lung Cancer. Cancers (Basel). 2018;10(3):72.

Roy-Chowdhuri S. Immunocytochemistry of cytology specimens for predictive biomarkers in lung cancer. Transl Lung Cancer Res. 2020;9(3):898-905.

Au NH, Gown AM, Cheang M, Huntsman D, Yorida E, Elliott WM, et al. P63 expression in lung carcinoma: a tissue microarray study of 408 cases. Appl Immunohistochem Mol Morphol. 2004;12(3):240-7.

Pelosi G, Pasini F, Olsen Stenholm C, Pastorino U, Maisonneuve P, Sonzogni A, et al. p63 immunoreactivity in lung cancer: yet another player in the development of squamous cell carcinomas? J Pathol. 2002;198(1):100-9.

Uke M, Rekhi B, Ajit D, Jambhekar NA. The use of p63 as an effective immunomarker in the diagnosis of pulmonary squamous cell carcinomas on de-stained bronchial lavage cytological smears. Cytopathology. 2010;21(1):56-63

Moses MA, George AL, Sakakibara N, Mahmood K, Ponnamperuma RM, King KE, et al. Molecular Mechanisms of p63-Mediated Squamous Cancer Pathogenesis. Int J Mol Sci. 2019;20(14):3590.

Affandi KA, Tizen NMS, Mustangin M, Zin RRMRM. p40 Immunohistochemistry Is an Excellent Marker in Primary Lung Squamous Cell Carcinoma. J Pathol Transl Med. 2018;52(5):283-289.

Lilo MT, Allison D, Wang Y, Ao M, Gabrielson E, Geddes S, et al. Expression of P40 and P63 in lung cancers using fine needle aspiration cases. Understanding clinical pitfalls and limitations. J Am Soc Cytopathol. 2016;5(3):123-32.

Delgado S, Guoping C. "p40 is Superior to p63 and CK5/6 for Differentiating Lung Squamous Cell Carcinoma from Adenocarcinoma in Cytological Specimens. J Am Society Cytopathol. 2017;6(5):S46.

Vogt A, Cohen C, Siddiqui M. p40 (ΔNp63) is more specific than p63 and cytokeratin 5 in identifying squamous cell carcinoma of bronchopulmonary origin: A review and comparative analysis. Diagn Cytopathol. 2013;42(5):453-8.

Bishop JA, Teruya-Feldstein J, Westra WH, Pelosi G, Travis WD, Rekhtman N. p40 (ΔNp63) is superior to p63 for the diagnosis of pulmonary squamous cell carcinoma. Mod Pathol. 2012;25:405-15

Righi L, Graziano P, Fornari A, Rossi G, Barbareschi M, Cavazza A, et al. Immunohistochemical subtyping of nonsmall cell lung cancer not otherwise specified in fine-needle aspiration cytology: a retrospective study of 103 cases with surgical correlation. Cancer. 2011;117(15):3416-23.

Nishino M, Hoang MP, Della Pelle P, Morales-Oyarvide V, Huynh TG, Mark EJ, et al. Napsin A/p40 antibody cocktail for subtyping non-small cell lung carcinoma on cytology and small biopsy specimens. Cancer Cytopathol. 2016;124(7):472-84.

Downloads

Published

2024-03-14

How to Cite

Rao, S. N., Vutukuru, A., Durga, K., Mithila, K. B., V., S., & Sreedhar, V. (2024). Study of p40 is superior to p63 for the diagnosis of pulmonary squamous cell carcinoma on cytological smears. International Journal Of Community Medicine And Public Health, 11(4), 1507–1512. https://doi.org/10.18203/2394-6040.ijcmph20240679

Issue

Section

Original Research Articles