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Zhao H, Qiu T, Guo H, Ying J, Li J, Zhang Z. Detection of EGFR and KRAS gene mutations using suspension liquid-based cytology specimens in metastatic lung adenocarcinoma. Oncotarget 2017; 8:106685-106692. [PMID: 29290981 PMCID: PMC5739766 DOI: 10.18632/oncotarget.22530] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 10/25/2017] [Indexed: 12/19/2022] Open
Abstract
Background The detection of EGFR and KRAS mutations of metastatic lung adenocarcinoma using liquid-based cytology suspension routine specimens from fine-needle aspiration remains controversial. Results The DNA of all specimens was extracted and real time PCR was performed successfully. The rate of EGFR and KARS mutations was 37.7% (58/154) and 5.8% (9/154), respectively. EGFR mutation rate was significantly higher in females than that in males (47.8% vs. 29.4%, P = 0.019). There were no significant differences among different age groups or different tumor sites. These results of EGFR and KRAS mutations using LBC specimens were consistant with the tissue samples. In 30 patients treated with tyrosine kinase inhibitors, complete response, partial response, stable disease and progress disease was observed in 2, 10, 13 and 5 patients, respectively. Conclusions Liquid-based cytology specimen is reliable and can be an alternative source for the detection of EGFR and KRAS mutations. Methods 154 fine-needle aspiration cytologic samples were obtained from patients with metastatic lung adenocarcinoma. The specimens included 21 cases of mediastinal lymph node 123 cases of neck nodules and 10 cases of subcutaneous nodules. After the diagnosis and count of tumor cells performed by cytopathologists, liquid-based cytology specimens with sufficient tumor cells were used for EGFR and KRAS testing using real-time PCR.
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Affiliation(s)
- Huan Zhao
- Department of Pathology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tian Qiu
- Department of Pathology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huiqin Guo
- Department of Pathology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianming Ying
- Department of Pathology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junling Li
- Department of Oncology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhihui Zhang
- Department of Pathology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yang Y, Yin W, He W, Jiang C, Zhou X, Song X, Zhu J, Fei K, Cao W, Jiang G. Phenotype-genotype correlation in multiple primary lung cancer patients in China. Sci Rep 2016; 6:36177. [PMID: 27796337 PMCID: PMC5087074 DOI: 10.1038/srep36177] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 10/12/2016] [Indexed: 11/09/2022] Open
Abstract
Due to recent advances in high-resolution detection technology, multiple primary lung cancer (MPLC) is becoming an increasingly common diagnosis. However, the genotype-phenotype correlations in MPLC patients have not yet been assessed. In this study, we analyzed the clinical and pathological data for 129 consecutive MPLC patients who received curative surgery at the Tongji University Shanghai Pulmonary Hospital, China. We have screened 129 patients in the present study and found mutations in EGFR, BRAF, ROS1 and KRAS genes, as well as the rearrangement of the EML4-ALK gene in 113 patients. The mean patient age was 59.9 (25-78) years old and 41 patients were males (31.8%). Among the total patients, 123 (95.4%) had two primary lesions, 5 (3.9%) had three primary lesions, and 1 (0.8%) had four primary lesions. In 38.8% of the patients, all lesions were located on only one side of the body. Most of the detected mutations (98 patients) were in the EGFR gene. The patients exhibited significant differences in the EGFR mutation, age at diagnosis, and foci location.
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Affiliation(s)
- Yang Yang
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Wei Yin
- Key Laboratory of Oral Biomedical Engineering of Ministry of Education, Hospital and School of Stomatology, Wuhan University, Wuhan 430079, China
| | - Wenxin He
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Chao Jiang
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Xiao Zhou
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Xiao Song
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Junjie Zhu
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Ke Fei
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Weijun Cao
- Department of Respiratory, Tongji University Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Gening Jiang
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai 200433, China
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Tseng JS, Wang CL, Huang MS, Chen CY, Chang CY, Yang TY, Tsai CR, Chen KC, Hsu KH, Tsai MH, Yu SL, Su KY, Wu CW, Yang CT, Chen YM, Chang GC. Impact of EGFR mutation detection methods on the efficacy of erlotinib in patients with advanced EGFR-wild type lung adenocarcinoma. PLoS One 2014; 9:e107160. [PMID: 25215536 PMCID: PMC4162576 DOI: 10.1371/journal.pone.0107160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 08/06/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Methods used for epidermal growth factor receptor (EGFR) mutation testing vary widely. The impact of detection methods on the rates of response to EGFR-tyrosine kinase inhibitors (TKIs) in EGFR-wild type (wt) lung adenocarcinoma patients is unknown. METHODS We recruited the Group-I patients to evaluate the efficacy of erlotinib in patients with EGFR-wt lung adenocarcinoma by either direct sequencing (DS) or mutant type-specific sensitive (MtS) methods in six medical centers in Taiwan. Cross recheck of EGFR mutations was performed in patients who achieved objective response to erlotinib and had adequate specimens. The independent Group-II lung adenocarcinoma patients whose EGFR mutation status determined by DS were recruited to evaluate the potential limitations of three MtS methods. RESULTS In Group-I analysis, 38 of 261 EGFR-wt patients (14.6%) achieved partial response to erlotinib treatment. Nineteen patients (50.0%) had adequate specimens for cross recheck of EGFR mutations and 10 of them (52.6%) had changes in EGFR mutation status, 5 in 10 by DS and 5 in 9 by MtS methods originally. In Group-II analysis, 598 of 996 lung adenocarcinoma patients (60.0%) had detectable EGFR mutations. The accuracy rates of the three MtS methods, MALDI-TOF MS, Scorpions ARMS and Cobas, were 87.8%, 86.8% and 85.8%, respectively. CONCLUSIONS A significant portion of the erlotinib responses in EGFR-wt lung adenocarcinoma patients were related to the limitations of detection methods, not only DS but also MtS methods with similar percentages. Prospective studies are needed to define the proper strategy for EGFR mutation testing.
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Affiliation(s)
- Jeng-Sen Tseng
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Chih-Liang Wang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Shyan Huang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Yu Chen
- Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
| | - Cheng-Yu Chang
- Division of Chest Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Tsung-Ying Yang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chi-Ren Tsai
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Molecular Biology, National Chung-Hsing University, Taichung, Taiwan
| | - Kun-Chieh Chen
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Kuo-Hsuan Hsu
- Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
- Division of Critical Care and Respiratory Therapy, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Meen-Hsin Tsai
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Sung-Liang Yu
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Center for Optoelectronic Biomedicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kang-Yi Su
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Wei Wu
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Ta Yang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yuh-Min Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Gee-Chen Chang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Comprehensive Cancer Center, Taichung Veterans General Hospital, Taichung, Taiwan
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