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Ruiz-Cordero R, Ma J, Khanna A, Lyons G, Rinsurongkawong W, Bassett R, Guo M, Routbort MJ, Zhang J, Skoulidis F, Heymach J, Roarty EB, Tang Z, Medeiros LJ, Patel KP, Luthra R, Roy-Chowdhuri S. Simplified molecular classification of lung adenocarcinomas based on EGFR, KRAS, and TP53 mutations. BMC Cancer 2020; 20:83. [PMID: 32005111 PMCID: PMC6995064 DOI: 10.1186/s12885-020-6579-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 01/24/2020] [Indexed: 01/25/2023] Open
Abstract
Background Gene expression profiling has consistently identified three molecular subtypes of lung adenocarcinoma that have prognostic implications. To facilitate stratification of patients with this disease into similar molecular subtypes, we developed and validated a simple, mutually exclusive classification. Methods Mutational status of EGFR, KRAS, and TP53 was used to define seven mutually exclusive molecular subtypes. A development cohort of 283 cytology specimens of lung adenocarcinoma was used to evaluate the associations between the proposed classification and clinicopathologic variables including demographic characteristics, smoking history, fluorescence in situ hybridization and molecular results. For validation and prognostic assessment, 63 of the 283 cytology specimens with available survival data were combined with a separate cohort of 428 surgical pathology specimens of lung adenocarcinoma. Results The proposed classification yielded significant associations between these molecular subtypes and clinical and prognostic features. We found better overall survival in patients who underwent surgery and had tumors enriched for EGFR mutations. Worse overall survival was associated with older age, stage IV disease, and tumors with co-mutations in KRAS and TP53. Interestingly, neither chemotherapy nor radiation therapy showed benefit to overall survival. Conclusions The mutational status of EGFR, KRAS, and TP53 can be used to easily classify lung adenocarcinoma patients into seven subtypes that show a relationship with prognosis, especially in patients who underwent surgery, and these subtypes are similar to classifications based on more complex genomic methods reported previously.
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Affiliation(s)
- Roberto Ruiz-Cordero
- Department of Pathology, University of California San Francisco, 1825 4th Street, Room L2181A, San Francisco, CA, 94158, USA.
| | - Junsheng Ma
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Abha Khanna
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Genevieve Lyons
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Waree Rinsurongkawong
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Roland Bassett
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ming Guo
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mark J Routbort
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jianjun Zhang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ferdinandos Skoulidis
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John Heymach
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Emily B Roarty
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zhenya Tang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Keyur P Patel
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rajyalakshmi Luthra
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sinchita Roy-Chowdhuri
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Guseva NV, Jaber O, Stence AA, Sompallae K, Bashir A, Sompallae R, Bossler AD, Jensen CS, Ma D. Simultaneous detection of single-nucleotide variant, deletion/insertion, and fusion in lung and thyroid carcinoma using cytology specimen and an RNA-based next-generation sequencing assay. Cancer Cytopathol 2018; 126:158-169. [DOI: 10.1002/cncy.21963] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/03/2017] [Accepted: 10/17/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Natalya V. Guseva
- Department of Pathology; University of Iowa Hospitals and Clinics; Iowa City Iowa
| | - Omar Jaber
- Department of Pathology; King Hussein Cancer Center; Amman Jordan
| | - Aaron A. Stence
- Department of Pathology; University of Iowa Hospitals and Clinics; Iowa City Iowa
| | | | - Amani Bashir
- Department of Pathology; University of Iowa Hospitals and Clinics; Iowa City Iowa
| | | | - Aaron D. Bossler
- Department of Pathology; University of Iowa Hospitals and Clinics; Iowa City Iowa
| | - Chris S. Jensen
- Department of Pathology; University of Iowa Hospitals and Clinics; Iowa City Iowa
| | - Deqin Ma
- Department of Pathology; University of Iowa Hospitals and Clinics; Iowa City Iowa
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Aronsson L, Andersson R, Swahn F, Ansari D. Does next-generation sequencing of cyst fluid improve management of pancreatic cystic neoplasms? Scand J Gastroenterol 2017; 52:1049-1051. [PMID: 28678564 DOI: 10.1080/00365521.2017.1349175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pancreatic cystic lesions represent a heterogeneous group of diseases ranging from benign to malignant lesions. They are increasingly being detected due to the widespread use of cross-sectional imaging. Their management is a challenge because it is often not possible to reliably discriminate between malignant and nonmalignant lesions using current imaging technology. Next-generation sequencing (NGS) has the ability of both whole genome and targeted sequencing at a low cost and from a limited amount of DNA. NGS of cyst fluid aspired by endoscopic ultrasonography-guided fine-needle aspiration provides a valuable tool in biomarker research and may in the future help improve diagnosis and management of pancreatic cystic lesions.
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Affiliation(s)
- Linus Aronsson
- a Department of Clinical Sciences Lund , Lund University, Skane University Hospital , Lund , Sweden Surgery
| | - Roland Andersson
- a Department of Clinical Sciences Lund , Lund University, Skane University Hospital , Lund , Sweden Surgery
| | - Fredrik Swahn
- a Department of Clinical Sciences Lund , Lund University, Skane University Hospital , Lund , Sweden Surgery
| | - Daniel Ansari
- a Department of Clinical Sciences Lund , Lund University, Skane University Hospital , Lund , Sweden Surgery
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