ASSESSMENT OF P63 IMMUNOHISTOCHEMICAL EXPRESSION IN LUNG CARCINOMA IN BANGLADESHI PATIENTS

Dr. Purabi Sarkar*, Dr. Mohammad Zillur Rahman, Dr. M Shahabuddin Ahmed, Dr. Rumana Mahmud, Dr. Syeda Nabila Islam Juthee and Dr. Siddhartha Baowaly

ABSTRACT

Background: Carcinoma of the lung is one of the major causes of cancer death. Lung tumors are histologically heterogeneous tumors with more than one histological type. The 2015 WHO classification recognizes four major histologic subtypes: squamous Cell Carcinoma (SCC), adenocarcinoma (ADC), large Cell Carcinoma and small Cell Carcinoma. Due to the recent advances in targeted therapies, subclassification of lung cancer has become increasingly important. p63 antibody panel can serve as a useful tool for subtyping of lung carcinoma in the bronchoscopic biopsy. Objectives: The purpose of this study was designed to determine the efficacy and role of p63 marker for the diagnosis of lung carcinoma. Methodology: This cross-sectional observational study was conducted in the Department of Pathology, Chittagong Medical College, Chattogram from March 2018 to February 2020. In this study, fifty-one biopsy samples of lung carcinoma were collected, processed, stained with hematoxylin, and eosin. Immunostaining for p63 was done in formalin-fixed paraffin-embedded tissue. All data were recorded in a pre-designed data sheet. Statistical analyses were carried out by using SPSS version 23 for Windows. A descriptive analysis was performed for all data. Observations were indicated by frequencies and percentages. Statistical significance was set at a “p” value<0.05. Result: In this study, The mean (±SD) age of the patients was 59.73 (±9.71) years with the minimum and maximum age of the patient were 38 years and 75 years respectively. A male predominance was observed in the series (86.3%). With regards to histological classification, 72.5% of patients had identified squamous cell carcinoma, 23.5% of patients had identified adenocarcinoma and only 2.0% of patients had identified as adenosquamous carcinoma and another 2.0% had small cell carcinoma. SCCs were more prevalent among males than females. In this study, 74.5% of patients were positive and 25.5% of patients were negative by p63 expression. Among the 37 squamous cell carcinoma patients, 81.1% of patients were positive and 18.9% of patients were negative by p63 expression. On the other hand, among the 14 patients, 57.1% of patients were positive and 42.9% of patients were negative by p63 expression in other than squamous cell carcinoma. There were higher sensitivity and positive predictive value. i.e. p63 expression could properly identify the squamous cell carcinoma. Moreover, due to the very limited number of adenosquamous carcinoma & small cell carcinoma, it was not possible to comment on the utility of p63 in such carcinoma. Conclusion: The study findings demonstrated p63 was found as a highly sensitive marker for squamous cell carcinoma. So, this panel p63 should be considered when confronted with a poorly differentiated pulmonary neoplasm of uncertain phenotype on bronchoscopic biopsy. A large scale prospective study with standardized techniques is desirable to validate the findings of the present study.

Keywords: Lung tumors, adenocarcinoma, cell Carcinoma, bronchoscopic biopsy.