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Lung pathology
1. Anatomy and Pathology of Lung
Cancer
Dr. Jyoti Priyadarshini Shrivastava
Associate Professor
Department of Pathology
Gajra Raja Medical College,Gwalior
2.
3. The lungs contain approximately 2,400 kilometres (1,500 mi) of airways and
300 to 500 million alveoli
4. Facts
• Most common and deadly cancer
• (12.6% of all new cancers, 17.8% of cancer
deaths).
• Sex ratio (M:F) is 2.7.
• Lung cancer is relatively more in the
developed countries,
• Geographic patterns are very much a
reflection of past exposure to tobacco.
5. Relative risk
• Active Smoke - 20 to 30 times
• Passive smoke - 1.5 times
(Public enemy no.1 is the commonest visceral
malignancy in MEN)
6. Present Scenario/Future Strategy
• Cancer is a disease of the cellular genome.
• Lung cancers show abundant genetic diversity.
• Genetic alterations, protein expression level and histology
comprehend the pathogenesis of lung cancer.
• Approx. 60% adenocarcinomas and 20% of squamous cell
carcinomas have an identified gene signature.
• Targeted therapies.
• Next-generation sequencing (NGS) technology offers the
ability to detect high-throughput, multiple genetic alterations
in both constitutional and cancer genomes.
• Lindeman NI, Cagle PT, Beasley MB, Chitale DA, Dacic S, Giaccone G, et al. Molecular testing
guideline for selection of lung cancer patients for EGFR and ALK tyrosine kinase inhibitors:. J
Thorac Oncol. 2013;8:823–859. [PMC free article] [PubMed]
• 2. Thunnissen E, van der Oord K, den Bakker M. Prognostic and predictive biomarkers in lung
cancer. A review. Virchows Arch. 2014;464:347–358. [PubMed]
7. Tobacco Smoking
• Tobacco = Bronchogenic carcinoma
• Frequency of lung cancer:
• 1.Amount. of daily smoking
• 2.Tendency to inhale
• 3.Duration of smoking
• Smokers--- 10x
• Heavy smokers (40 cig.)----20x
Bronchial epithelium---hyperplastic and
atypical epithelium
8. Industrial Hazard
• All radiations are carcinogenic.
1.Uranium- 4x
2.Smoking+ Uranium – 10 x
3.Asbestos – 5x
4.Nickel,coal,Mustard Gas,
Arsenic,Berrylium,Iron ,Newspaper
workers,Gold miners,Halo-ether workers.
21. EGRF Mutation
• EGFR mutation ---validated predictive marker
for response and progression-free survival
with EGFR tyrosine kinase inhibitors in
advanced lung adenocarcinoma.
• Patients with advanced adenocarcinomas be
tested for EGFR mutation.
22.
23. The Cancer Genome Atlas (TCGA)
Project
• TCGA's principal aims are to generate:
quality control, merge, analyze, and interpret
molecular profiles at the DNA, RNA, protein,
and epigenetic levels .
• Hundreds of clinical tumors from various
tumor types and their subtypes
24. A variety of genes involved in targeted treatment of
non-small cell lung cancer along with their respective
histologic subtypes and the method of detection
