Evolution of Lung Cancer Diagnoses Over a 10-year Period at the VA Medical Center in San Diego : The Impact of Advanced Techniques on Surgical and Cytological Diagnostic Practices.
The purpose of this project is to investigate various advances in technique and practice patterns for biopsy acquisition and diagnosis for Non-Small Cell Lung Cancer subtypes at the VA Medical Center in San Diego between 2002-2013. Thus far, our experience at the VA for the past 10 years has shown that increased use of immuno-histochemistry in combination with morphologic assessment has correlated with an increase in cases diagnosed as adenocarcinoma, squamous cell carcinoma or mixed adenosquamous carcinoma. We have yet to investigate if using the most commonly used stains such as CK5, TTF1, P63 and Napsin A actually help to differentiate these cancer subtypes versus cases that did not use all 4 stains. Furthermore, the modality of sample acquisition such as CT-Guided FNA or biopsy versus Endobronchial FNA or biopsy (with or without Ultra-sound guidance) from all cases of lung cancer from 2002 to 2013 have yet to be analyzed and compared in terms of efficacy for NSLC diagnosis. Lastly, information regarding all cases that were sent for molecular testing results pertaining to EGFR and ALK status, as these mutations are clinically important for treatment and progression-free survival, have not yet been retrieved or assessed. This project seeks to investigate the described questions by data acquisition and analysis.