Molecular Alterations in Pulmonary Adenocarcinoma of African Americans: A Single Institutional Experience

Erika Rodriguez, Robert Jones, C. Paul Morris, David Ettinger, Sayanan Chowsilpa, Zahra Maleki

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives Identify molecular alterations in pulmonary adenocarcinoma (ADC) in African American (AA) patients diagnosed on cytology specimens. Methods After institutional review board approval, we searched our database from 2013 to 2017 for AA patients with a diagnosis of pulmonary ADC. Molecular and clinical data were reviewed. White patients also diagnosed with pulmonary ADC on cytology samples formed a control group. Results A total of 113 patients were identified. Mean age was 63.4 years. Molecular tests were available for 91 patients. Mutations were identified in 53 (58.2%) cases. The most common mutations were EGFR (n = 19 cases, 36%) and KRAS (n = 24 cases, 45%). When compared with whites, AA patients were diagnosed at higher stages (P = .045) and demonstrated shorter overall survival (17 vs 47 months, P = .0150). No differences were noted regarding distribution of molecular alterations. Conclusion AA patients have similar molecular alterations in ADCs as their white counterparts. However, they have worse outcomes. Lung cancer is the leading cause of cancer death in the United States and worldwide. Although there are many different morphologic subtypes, pulmonary cancer has been traditionally divided in two major histologic groups: non-small cell carcinoma (NSCLC) and small cell carcinoma. NSCLC represents approximately 80% of lung cancers, with a survival rate of 15% at 5 years. The two major subtypes of NSCLC are adenocarcinoma (ADC) and squamous cell carcinoma. In recent years, the field of thoracic oncology has experienced major advances in the understanding of molecular alterations of pulmonary ADC, which has resulted in the development of targeted therapies. Studies suggest that mutations in ADC vary across ethnic groups, sexes, and smoking status. For example EGFR mutations are more common is women, nonsmokers, and patients of Asian descent. Cytology has emerged as an important tool not only to diagnose pulmonary cancer but also to guide therapy. In the United States, the incidence of lung cancer is higher in AAs than in any other ethnic groups, but studies focusing on the specific characteristics of this group are sparse. Prior studies report that the overall 5-year survival rate is lower in AAs (14%) compared with non-Hispanic whites. Nevertheless, the somatic mutations associated with pulmonary ADC in AAs are not well studied. The aim of our study is to identify clinical and biologic features of pulmonary adenocarcinoma in the AA population.

Original languageEnglish (US)
Pages (from-to)237-242
Number of pages6
JournalAmerican journal of clinical pathology
Volume152
Issue number2
DOIs
StatePublished - 2019

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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