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Year : 2022  |  Volume : 65  |  Issue : 6  |  Page : 2-3
K. C. Basu Mallik awards paper abstracts

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Date of Web Publication28-Nov-2022

How to cite this article:
. K. C. Basu Mallik awards paper abstracts. Indian J Pathol Microbiol 2022;65, Suppl S2:2-3

How to cite this URL:
. K. C. Basu Mallik awards paper abstracts. Indian J Pathol Microbiol [serial online] 2022 [cited 2023 Feb 3];65, Suppl S2:2-3. Available from:

   Abstract 1 Top

Targetable mutations in non-small cell lung cancer: Prevalence in tissue and cell-free nucleic acid and its influence on survival outcome

P Radha, R Lingaiah, N Kumari, S Singh, N Krishnani, A Nath

Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow

Background: Molecular testing for targetable mutations in NSCLC affords immense therapeutic potential in most cases. Liquid biopsy is recommended as an alternative to tissue biopsy when the latter is inadequate or unobtainable in NSCLC. In this study, we evaluated the concurrent testing of targetable mutations EGFR, ALK, ROS1 and MET in tissue and plasma samples and correlated their status with overall survival outcome. Materials and Methods: One hundred treatment-naive NSCLC patients were recruited after histological confirmation of the diagnosis. Ten ml of blood was collected within a period of two weeks from diagnosis, prior to the start of any treatment. DNA extraction from formalinfixed paraffin embedded (FFPE) tissue was done. Plasma was separated by double centrifugation and cell-free nucleic acid extraction was done. EGFR mutation, ALK, ROS1 and MET rearrangements were tested by ARMS (Amplification Refractory Mutation System) PCR. All statistical analyses were conducted in R version 4.1.1. Results: A total of 60 cases showed molecular alterations in tissue samples for EGFR, ALK and ROS1 combined, with 47 of them being EGFR mutations, 12 cases of ALK rearrangement and 2 cases of ROS1 fusion. One case showed concurrent EGFR mutation and ALK rearrangement. MET alteration was not detected in any of the cases. Forty-three cases showed EGFR mutation in plasma with a concordance of 62%. ALK-EML4 rearrangement and ROS1 fusion were not detected in cell-free samples. Sensitivity and specificity for detection of EGFR mutation in plasma were 55.3% and 67.9% respectively. Thirty one of the 47 tissue EGFR mutant cases and 3 of the 12 ALK positive cases received TKI based therapy. Univariate Cox regression analysis showed tissue mutation status and targeted therapy (OS:HR = 0.29; 95% CI: 0.1–0.8; p = 0.02) as the significant factors associated with overall survival (OS). The OS after therapy for tissue EGFR mutant and tissue EGFR wild type was found to be 19 months and 9 months respectively. However, when OS in plasma EGFR positive cases was compared with plasma wild type cases, there was no significant difference (p=0.34). Discussion and Conclusion: The findings in this study emphasise the role of liquid biopsy as complementary to molecular testing in tissue. Prevalence of EGFR mutation increased from 47% to 64% indicating that several cases which may be missed on tissue testing can be afforded the benefit of targeted therapy if tested simultaneously in liquid biopsy. However, negative cases must always be confirmed by corresponding tissue testing.

Keywords: ALK, EGFR, MET, non-small cell lung cancer, ROS1

   Abstract 2 Top

Granulomas co-occurring in malignancies – Tale of aetiological relationship

Sacheeta Babuta, Cheena Garg, Arjun Agarwal, Ranjan Agrawal

Rohilkhand Medical College, Bareilly, Uttar Pradesh, India

Introduction: Granulomatous inflammation is one of the common diagnosis in pathology in India. In patients with malignancy, granulomatous lesions included as a part of primary tumor or nodal granulomas may quite often be a fortuitous finding. The exact aetiology of this mechanism or the therapeutic implication in cancer patients remains obscure. Aim: To determine the possible aetiopathogenesis of co-occurrence of granulomas with different malignancies in different body sites. Materials and Methods: All cases with granuloma formation observed in draining lymph nodes or in primary site of malignant tumors were included in the present study. After routine histopathology examination, modified Ziehl-Neelsen (ZN) staining for Mycobacteria was carried out in all the cases. Detailed history especially of Tuberculosis, sarcoidosis, neoadjuvant chemotherapy, radiation or previous procedure was recorded. Results: 11 out of 35 cases (31.4%) had granulomas within the primary tumor, while 24 cases out of 35 (68.6%) showed nodal granulomas. Of the 24 cases, 5 cases had nodal metastatic tumor deposits. Also, necrotizing granulomas with AFB were significantly more as compared to AFB in non-necrotizing granulomas (p value of 0.05). Of the total cases, 20% had an attributed risk factor. 3 cases received neoadjuvant chemotherapy and 3 had history of systemic tuberculosis while one case had associated Crohn's disease. Conclusion: We recommend to characterise granulomas as necrotizing/non-necrotizing, confluent/discrete, tumor deposit present/absent; prior history of systemic/local illnesses (like- SS, TB, fungal infections, IBD, etc.); prior history of CT/RT; and to follow routine ZN staining in all cases of granulomas with malignancy.

Keywords: Granulomas, malignancy, sarcoidosis, tuberculosis, ZN staining

   Abstract 3 Top

Among COVID-19 hospitalized patients does D-dimer value at the time of admission predict future outcome

Anju Shukla, Fatema Shareh Naqvi, Areena Hoda Siddiqui, Surbhi Gupta, Priyanka Jain

Sahara Hospital, Lucknow, Uttar Pradesh, India

Background and Objectives: Covid- 19 is still going on with lots of uncertainties and probabilities. Second wave was almost devastating with high mortality rate and there is a need for early and effective marker for management and prognostication of Covid-19 patients. Coagulation dysfunction and increased D-dimer levels are seen in this disease. Thus present study was aimed to compare D-dimer value in relation to disease severity and disease mortality, and to evaluate prognostic significance of D-dimer. Methods: All symptomatic Covid-19 patients confirmed with SARS-CoV-2 RT-PCR qualifying specific admission criteria admitted in Sahara Hospital from March 31, 2021, to May 31, 2021 were evaluated and clinical, demographical and laboratory findings were collected and analysed. According to disease severity patients were grouped and death events and D-dimer value were assessed. Optimal D-dimer cut off point by receiver operating curve in all groups and among survivors and non-survivors were evaluated. Results: 388 patients were included in the study out of which 142 (36.5%) died during hospital stay. Mean D-dimer value in mild disease was 1.17±0.21, moderate disease was 1.47±0.17 and in severe disease was 2.92±0.23 FEUμg/ml. Mean D-dimer value in non-survivors are significantly (P0.78 in mild cases, >1.05 in moderate patients and >2.11 in severe cases. Conclusion: Mean D-dimer value showing increasing trend with increase disease severity and prognostic significance was found highest in moderate patients followed by mild patients and least in severe patients in terms of mortality.

Keywords: COVID-19, D-dimer, optimal cut off

   Abstract 4 Top

Molecular and immunohistochemical analysis of sinonasal carcinomas for identification of novel genetically defined entities

K M Subiyathul Farah Ashraf, Aanchal Kakkar, Amber Rathor, Kavneet Kaur, Kapil Sikka, Deepali Jain

AIIMS, New Delhi, India

Background: Sinonasal carcinomas consist of a heterogeneous group that until recently were classified based on histomorphology and immunophenotype, the most common being squamous cell carcinoma (SCC), sinonasal undifferentiated carcinoma (SNUC), and poorly differentiated carcinomas which cannot be characterized further. With increasing availability of advanced techniques, several novel molecularly defined entities have emerged, viz. NUT carcinoma, SMARCB1/INI1-deficient carcinoma, SMARCA4/BRG1-deficient carcinoma, IDH-mutant carcinoma, high-risk human papillomavirus (HR-HPV)-associated SCC and DEK AFF2 carcinoma, each with prognostic and/or therapeutic implications. Methods: We reviewed cases of sinonasal carcinomas diagnosed over 12 years, and grouped them into “poorly/undifferentiated carcinoma” (PDUCa) which encompassed SNUC, Neuroendocrine Carcinoma (NEC) and Teratocarcinosarcoma (TCS), while all squamous cell carcinomas (SCC) were grouped together. Immunohistochemistry for NUT, SMARCB1/INI1, SMARCA4/BRG1 and IDH, and IDH1/2 mutation analysis were performed in all PDUCa, while SCC were evaluated for p16 and AFF2 immunostaining, HR-HPV by mRNA in situ hybridization (ISH), and DEK rearrangement by fluorescence in situ hybridization (FISH). Results: Ten NUT carcinomas, 17 SMARCB1/INI1-deficient carcinomas, 14 SMARCA4/BRG1-deficient carcinomas, and 20 IDH-mutant carcinomas were identified. The SCC group yielded one DEK:AFF2 carcinoma. Nine SCC were p16 positive, but were negative for HR-HPV by mRNA ISH. Overall, 62 cases (36% of all PDUCa and SCC) were identified as molecularly defined entities. Of these, 44 cases (71%) could be diagnosed by IHC alone. Conclusion: With careful evaluation of histomorphological features of sinonasal PDUCa and SCC and use of a judicial immunohistochemical panel, most molecularly defined carcinomas can be identified, necessitating molecular testing in a small subset of cases.

Keywords: Sinonasal carcinoma, SMARCA4/BRG1, SMARCB1/INI1

   Abstract 5 Top

Is C4d the magical marker in diagnosis of native renal diseases?

Varsha Kumar, Arun Yadav, Satyam, Vatsala Misra, Arvind Gupta, Premala Anthony Singh

M.L.N. Medical College, Prayagraj, Uttar Pradesh, India

Introduction: C4d is a biomarker of the complement cascade and has a role in the of antibody mediated rejection in solid organ transplantation. It's role in disease progression has been studied recently in few native renal diseases. Materials and Methods: An observational cross-sectional study was conducted in the Department of Pathology from September 2020 to September 2021. A total of 93 renal biopsies of patients presenting with proteinuria/azotemia/isolated glomerular hematuria were included in the study. The semiquantitative intensity of Immunoglobulins and complements obtained on IF were correlated with the semiquantitative intensity of C4d by IHC. Statistical analysis was done by Pearson correlation coefficient to determine the P value. Results: Positive correlation was found between the IF deposits of immunoglobulins and C3 in the glomerulus with the C4d deposits demonstrated by immunohistochemistry, in Minimal change disease and membranous nephropathy (R2= 1, 0.769). Weak positive correlation was obtained in case of MPGN and Lupus nephritis (R2=0.33, 0.06). Conclusion: Pattern of glomerular C4d deposition can be a useful for diagnosing various diseases like MCD, MN, Lupus Nephritis, Membranoproliferative glomerulonephritis, IgA nephropathy. Given its diagnostic importance, staining for C4d might be incorporated into the routine analysis of renal biopsies.

Keywords: C4d, renal diseases

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0377-4929.362055

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