Clinical Characteristics and Molecular Profiles of Lung Cancer in Ethiopia.

Autor:	Gebremariam TH; Department of Internal Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia., Haisch DA; Division of Pulmonary & Critical Care Medicine, Weill Cornell Medical College, New York City, New York., Fernandes H; Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York., Huluka DK; Department of Internal Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia., Binegdie AB; Department of Internal Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia., Woldegeorgis MA; Department of Oncology, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia., Ergetie W; Department of Pathology, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia., Worku A; Department of Internal Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia., Zerihun LM; Columbia University Vagelos College of Physicians and Surgeons, New York, New York., Cohen M; Columbia University Vagelos College of Physicians and Surgeons, New York, New York., Massion PP; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee., Sherman CB; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island., Saqi A; Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York., Schluger NW; Department of Medicine, New York Medical College (NYMC) School of Medicine, New York City, New York.
Jazyk:	angličtina
Zdroj:	JTO clinical and research reports [JTO Clin Res Rep] 2021 May 31; Vol. 2 (7), pp. 100196. Date of Electronic Publication: 2021 May 31 (Print Publication: 2021).
DOI:	10.1016/j.jtocrr.2021.100196
Abstrakt:	Introduction: Lung cancer is the most common cause of cancer deaths worldwide, accounting for 1.8 million deaths each year. Only 20% of lung cancer cases are reported to occur in low- and middle-income countries. An estimated 1.5% of all Ethiopian cancers involved the lung; however, no nationwide cancer registry exists in Ethiopia. Thus, accurate data on clinical history, histopathology, molecular characteristics, and risk factors for lung cancer are not available. The aim of this study was to describe the clinical, radiologic, and pathologic characteristics, including available molecular profiles, for lung cancer at Tikur Anbessa Specialized Hospital (TASH), the main tertiary referral center in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted at TASH among 146 patients with pathologically confirmed primary lung cancer, diagnosed from 2015 to 2019 and recorded in the Addis Ababa Cancer Registry at TASH. Clinical data were extracted from patient medical records, entered into a Research Electronic Data Capture database, and analyzed using Statistical Package for the Social Sciences statistical software. Variables collected included sociodemographics, personal exposures, comorbidities, clinical manifestations at presentation, chest imaging results, diagnostic procedures performed, histopathological classification, cancer staging, and type of treatment (if any). A subset of lung biopsies fixed in formalin for 2 to 7 days, which could be retrieved from the files of the Pathology Department of TASH, were reviewed, and molecular analysis was performed using next-generation sequencing to identify the tumor-oncogenic drivers. Results: Among the 146 patients studied, the mean (SD) age was 54 plus or minus 13 years; 61.6% (n = 90) were male and 25.3% (n = 37) had a history of tobacco use. The most common clinical manifestations included cough (88.4%, n = 129), chest pain (60.3%, n = 88), and dyspnea (53.4%, n = 78). The median duration of any symptoms was 6 months (interquartile range: 3-12 mo). The most common radiologic features were lung mass (84.9%, n = 129) and pleural effusion (52.7%, n = 77). Adenocarcinoma accounted for 35.7% of lung cancers (n = 52) and squamous cell carcinoma 19.2% (n = 28) from those specimens was reported. Among patients on whom staging of lung cancer was documented, 92.2% (n = 95) of the subjects presented at advanced stages (stages III and IV). EGFR mutation, exons 19 and 20, was found in 7 of 14 tissue blocks analyzed. No specific risk factors were identified, possibly reflecting the relatively small sample size and limited exposures. Conclusions: There are marked differences in the presentation, risk factors, and molecular characteristics of lung cancer in Ethiopia as compared with other African and non-African countries. Adenocarcinoma was the most common histologic type of lung cancer detected in our study, similar to findings from other international studies. Nevertheless, compared with high-income countries, lung cancer in Ethiopia presents at a younger age, a later stage, and without considerable personal tobacco use. The relatively higher prevalence of EGFR mutation, from the limited molecular analyses, suggests that factors other than smoking history, such as exposure to biomass fuel, may be a more important risk factor. Country-specific screening guidelines and treatment protocols, in addition to a national tumor registry and greater molecular mutation analyses, are needed to improve prevention and management of lung cancer in Ethiopia. (© 2021 The Authors.)
Databáze:	MEDLINE
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