Molecular and immunohistochemical diagnosis to guide treatment in non-small cell lung adenocarcinoma

Authors

  • Danitza Elias Justiniani Hospital Clínico-Quirúrgico Hermanos Ameijeirias
  • Laura Cristina Bastien Valdovinos
  • Jazmin Ruiz Cruz Hospital Clínico-Quirúrgico Hermanos Ameijeirias
  • Franguia Govea Sosa Hospital Clínico-Quirúrgico Hermanos Ameijeirias
  • Brenda Martínez Luna Hospital Clínico-Quirúrgico Hermanos Ameijeirias
  • Dayanis Duvergel Calderín Hospital Clínico-Quirúrgico Hermanos Ameijeirias

Keywords:

adenocarcinoma, non-small cells, lungs, EGFR, ALK, PDL-1.

Abstract

Introduction: Lung neoplasms are the second leading cause of death in the world. Adenocarcinoma is the most frequent celltype and represents more than 50% of cancers. Lung cancers can be treated in different ways depending on the histological subtype and molecular diagnosis.

Objective: Analyze the importance of molecular and immunohistochemical studies to direct a precise treatment for lung cancer, histological type non-small cell carcinoma.

Case presentation: In this case of a 59 year old female who presented a chronic cough with no other symptoms and medical history. A computed tomography image found a mass in close contact with the left upper lobar bronchus branch that measure 41 x20mm. It was attain a biopsy by thick needle in the left upper lobe, conventional histochemical process. Immunohistochemical markers were requested for Anaplastic Lymphoma Kinase (D5F3), Programed Death Ligand 1and molecular biology test for Epidermal Growth Factor Receptor.

Results: Conventional hematoxylin and eosin histochemistry showed the presence of non-small cell lung carcinoma, with adenocarcinoma histological subtype, moderately differentiated. The results for immunohistochemistry were negative for the markers Anaplastic Lymphoma Kinase (D5F3) and Programed Death Ligand 1. The molecular report for Epidermal Growth Factor Receptor turned out in mutated gene.

Conclusions: Identifying a biomarker and its over expression with respect to others allows us to determine the group of patients that will benefit from more specific therapies according to the pathogenesis of their cancer.

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Author Biographies

Danitza Elias Justiniani, Hospital Clínico-Quirúrgico Hermanos Ameijeirias

Medico General egresada en México , actualmente residente cursando el primer año de especialidad en Anatomia Patológica en Hospital Clínico-Quirúrgico Hermanos Ameijeirias, La Habana, Cuba.

Dayanis Duvergel Calderín, Hospital Clínico-Quirúrgico Hermanos Ameijeirias

Especialista en Primer Grado de Anatomía Patológica y Medicina General Integral. Máster en Citopatología y Enfermedades infecciosas. Profesor Asistente.

References

International Agency for Research on Cancer. Lung. Source: Globocan 2020. WHO. 2021. Disponible en: https://gco.iarc.fr/today/data/factsheets/cancers/15-Lung-fact-sheet.pdf

Planchard D, Novello S, Peters S. Cancer de pulmón de células no pequeñas (CPCNP). Una Guía ESMO para pacientes. ESMO. 2019. Disponible en: https://www.esmo.org/content/download/7253/143223/file/ES-Cancer-de-Pulmon-de-Celulas-no-Pequenas-Guia-para-Pacientes.pdf

Duffy M, O´Byrne K. Tissue and Blood Biomarkers in Lung Cancer: A review. Advanc Clinic Chemistry. 2018;86:1-26. DOI: http://doi.org/10.1016/bs.acc.2018.05.001

Barrionuevo Cornejo C, Dueñas Hanco D. Clasificación actual del carcinoma de pulmón. Consideraciones histológicas, inmunofenotípicas, moleculares y clínicas. Horiz Med (Lima). 2019;19(4):74-83. DOI: http://dx.doi.org/10.24265/horizmed.2019.v19n4.11

Fernandez S, Pires Y, Labarca G, Vial M. Expresión de PDL-1 en muestras de cáncer pulmonar no microcítico obtenidas por EBUS_TBNA. Arch Bronconeumol. 2018;54(5):284-96. DOI: http://doi.org/10.1016/j.arbes.2017.10.008

Zhang Chao, Leighl N, Wu YL, Zhong WZ. Emerging theraphies for non-small cell lung cancer. J Hemat&Oncol. 2019;12:45. DOI: http://doi.org/10.1186/s13045-019-0731-8

Sánchez C, Rodríguez J, Martínez L, Santillan P, Alatorre J. Adenocarcinoma pulmonar con arreglo ALK: un fenotipoclínico y tomográfico distinto. Neumol Cir Torax. 2020;79(1):26-30. DOI: https://dx.doi.org/10.35366/93426

Ji M, Liu Y, Li Q, Li X, Ning Z, Zhao W, et al. PD-1/PD-L1 expression in non- small-cell lung cancer and its correlation with EGFR/KRAS mutation. Cancer Biolog&Therapy. 2016;17(4),407-13. DOI: http://dx.doi.org/10.1080/15384047.2016.1156256

Yatabe Y, Dacic S, Borczuk A, Warth A, Russell P, Lantuejoul S, et al. Best practices recommendations for diagnostic immunohistochemistry in lung cancer. J Thoracic Oncology. 2018;14(3):377-407. DOI: http://doi.org/10.1016/j.jtho.2018.12.005

Egoavil Guerra MJ, Failoc Rojas VE, Gil Olivares F, Motta Guerrero R, Payet Meza ET, Sarria Bardales G, et al. Detección de mutaciones del gen EGFR en ADN circulante por medio de biopsia líquida en pacientes con cáncer pulmonar de células no pequeñas: revisión rápida. Acta Med Peru. 2021;38(2):145-50. DOI: https://doi.org/10.35663/amp.2021.382.1978

Lucian R. Chirieac, Richard L. Attanoos. Usual lung cancer. En: Dani S, Carol F. (editors). Pulmonary Pathology. Philadelphia: Elsevier; 2018. pp. 534-51.

Kuykendall A, Chiappori A. Advanced EGFR Mutation-Positive Non-Small-Cell Lung cancer: Case Report, Literature Review, and Treatment Recommendations. J Moffitt Cancer Center. 2014;21(1):67-73. DOI: https://doi.org/10.1177/107327481402100110

Thumallapally N, Yu H, Farhan M, Ibrahim U, Odiami M. Concomitant Presence of EGFR and ALK Fusion Gene Mutation in Adenocarcinoma of Lung: A Case Report and Review of Literature. J Pharmacy Practice. 2017;20(2):1-5. DOI: https://doi.org/10.1177/0897190017704751

Esteban Rodríguez M. Estudio Inmunohistoquímico de PD-L1 y del Microambiente tumoral en una cohorte de carcinomas de pulmón de células no pequeñas. Correlación con factores pronósticos y expresión genética [tesis de grado]. Universidad Autónoma de Madrid: Facultad de Medicina; 2019.

Diagnostics Roche. Identifying ALK (D5F3) + NSCLC patients for targeted treatment. Last Updates.Diagnostics Roche. 2022 [acceso: 23/07/2021]. Disponible en: https://diagnostics.roche.com/global/en/products/tests/ventana-alk_d5f3-cdx-assay1.html

Diagnostics Roche. Prueba Ventana PD-L1 (SP263) (CE-IVD). Last updates. Diagnostics Roche. 2022. https://diagnostics.roche.com/global/en/products/tests/ventana-pd-l1-_sp263-assay2.html

Published

2022-12-28

How to Cite

1.
Elias Justiniani D, Bastien Valdovinos LC, Ruiz Cruz J, Govea Sosa F, Martínez Luna B, Duvergel Calderín D. Molecular and immunohistochemical diagnosis to guide treatment in non-small cell lung adenocarcinoma. Acta Médica [Internet]. 2022 Dec. 28 [cited 2025 Mar. 13];23(4). Available from: https://revactamedica.sld.cu/index.php/act/article/view/296

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Section

Presentación de caso