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A study of the sociodemographic, clinical, pathological and radiological profile of lung cancer in a tertiary care center

Silpa Kshetrimayum, Anand Srivastava, Surya Kant, Ajay Kumar Verma, Ved Prakash, Darshan Kumar Bajaj, Nuzhat Husain, M. L. B. Bhatt.

Background: Lung cancer now constitutes the majority of all cancer diagnosis in the world. It has the most unfavourable prognosis accounting for the maximum number of cancer related deaths worldwide. The objective of this study was to study the complete profile of lung cancer. Prevalence of EGFR mutation in adenocarcinoma.
Methods: 116 lung cancer patients were enrolled. They were subjected to diagnostic procedures like transthoracic FNAC/biopsy, bronchoscopy, thoracoscopy, closed pleural biopsy, lymph node FNAC/biopsy, besides routine blood and sputum examinations and CECT thorax. Data was analysed retrospectively after 1 year.
Results: Most patients presented in the sixth decade. Mean duration of symptoms was 7.24 months. 62% patients were smokers, 54.3% were exposed to non-smoke tobacco, 18.9% to environmental tobacco smoke (ETS) and biomass fuel. Mass as the single radiological lesion was the most common radiological finding. Pleural effusion was seen in 51.7% patients and was more common in females. Liver (3.4%) and brain (5.9%) were the most common sites of metastasis. EGFR mutation was positive in 34.2% of adenocarcinoma. Exon 19 deletion was more common. ALK was positive in 1 patient. Maximum number of patients (70.7%) presented in stage 4. Transthoracic biopsy could diagnose 61.2% of all lung cancers. Adenocarcinoma was the most common diagnosis (60.3%) and was more common in females and non-smokers.
Conclusions: Most patients present in an advanced stage. Adenocarcinoma now seems to be the most common histological subtype of lung cancer in India. EGFR mutation is common in the Indian population. Biomass fuel exposure is a significant risk factor in females. Bronchoscopy is the procedure of choice for diagnosing central tumours and transthoracic FNAC and Biopsy for peripheral tumours.

Key words: Adenocarcinoma, EGFR, Lung cancer, NSCLC, Smokers

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