Immunohistochemical staining and computed tomography in early detection of lung cancer among heavy smokers: A pilot study

Abstract

ObjectivesEarly diagnosis of lung cancer carries a good prognosis. The aim of the present study was early detection of lung cancer among heavy smokers using immunohistochemical staining and chest computed tomography (CT).Patients and methodsThis descriptive cross-sectional study comprised 80 heavy smokers with smoking index more than 40 pack-years. They were recruited from the Smoking Cessation Clinic, Mansoura University Hospital. All participants were subjected to (a) chest radiography followed by high-resolution chest CT, (b) sputum sample collection, and (c) fiberoptic bronchoscopy evaluation of bronchoalveolar lavage (BAL) and bronchial mucosal biopsies from suspicious areas. All pathological samples were stained with hematoxylin and eosin followed by immunostaining using antibodies for p53 and thyroid transcription factor-1 (TTF-1). Data were analyzed using statistical package for social sciences, version 16.ResultsThe majority of heavy smokers were male, withamean age of 53.42±11.30 years. A solitary pulmonary nodule was detectedin1.3%of cases withchest radiographyandin5%with high-resolution CT. Hematoxylin and eosin staining of sputum, BAL, and mucosal biopsies was positive for premalignant changes in 35, 27, and 17.56%of cases, respectively. Sputum, BAL, and mucosal biopsies showed expression of p53 in 30, 37.8, and 35.1% of cases, respectively. Sputum, BAL, and mucosal biopsy showed expression of TTF-1 in 12.5, 10.8, and 14.9% of cases, respectively.ConclusionThe immunohistochemical technique using p53 and TTF-1 is useful in the early detection of bronchial mucosal changes in heavy smokers. There is still need for a largescale study to highlight its validity and acceptability. Meanwhile, chest CT is beneficial for the detection of peripheral small lesions.