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Paturu R, Lingaiah R, Kumari N, Singh S, Krishnani N, Srivastava S, Siddiqui SH, Nath A. Non-Small Cell Lung Cancer: Targetable Variants in Concurrent Tissue and Liquid Biopsy Testing in a North Indian Cohort. Asian Pac J Cancer Prev 2023; 24:3467-3475. [PMID: 37898852 PMCID: PMC10770664 DOI: 10.31557/apjcp.2023.24.10.3467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 10/11/2023] [Indexed: 10/30/2023] Open
Abstract
OBJECTIVES Testing for EGFR, ALK, ROS1 and MET alterations in paired tissue and plasma samples of treatment-naïve patients of NSCLC and correlating their status with overall survival. MATERIALS AND METHODS One hundred treatment-naïve patients were recruited after obtaining informed consent. Ten ml of blood was collected within a period of two weeks from histological diagnosis, prior to the start of any treatment. DNA & RNA extraction was done from formalin-fixed paraffin embedded (FFPE) tissue and total cell-free nucleic acid extraction was done from plasma samples. 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 61 cases showed molecular alterations in tissue samples which included EGFR mutations (47), ALK rearrangements (12), ROS1 fusion (2). MET alteration was not detected. Forty-three cases showed EGFR mutations in plasma, 26 of which were concurrently positive in tissue. Concordance observed was 62%. ALK-EML4 rearrangement, ROS1 fusion and MET were not detected in plasma samples. Sensitivity and specificity for detection of EGFR mutation in plasma were 55.3% and 67.9% respectively. Univariate Cox regression analysis showed a positive association between EGFR mutation in tissue and overall survival (HR = 0.4; 95% CI: 0.2-0.7; p = 0.003) and improved overall survival in those who received targeted therapy (HR = 0.29; 95% CI: 0.1-0.8; p = 0.02). CONCLUSION Concurrent testing in tissue and liquid biopsy in NSCLC increased the detection of EGFR mutations (47% to 64%). This has substantial implications in deciding treatment and administration targeted therapy and the consequent overall survival.
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Affiliation(s)
- Radha Paturu
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | - Raghavendra Lingaiah
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | - Niraj Kumari
- Department of Pathology & Lab Medicine, AIIMS Raebareli, Raebareli, Uttar Pradesh, India.
| | - Shalini Singh
- Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | - Narendra Krishnani
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | - Shreya Srivastava
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | - Saima Haleem Siddiqui
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | - Alok Nath
- Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
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Ren XD, Su N, Sun XG, Li WM, Li J, Li BW, Li RX, Lv J, Xu QY, Kong WL, Huang Q. Advances in liquid biopsy-based markers in NSCLC. Adv Clin Chem 2023; 114:109-150. [PMID: 37268331 DOI: 10.1016/bs.acc.2023.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Lung cancer is the second most-frequently occurring cancer and the leading cause of cancer-associated deaths worldwide. Non-small cell lung cancer (NSCLC), the most common type of lung cancer is often diagnosed in middle or advanced stages and have poor prognosis. Diagnosis of disease at an early stage is a key factor for improving prognosis and reducing mortality, whereas, the currently used diagnostic tools are not sufficiently sensitive for early-stage NSCLC. The emergence of liquid biopsy has ushered in a new era of diagnosis and management of cancers, including NSCLC, since analysis of circulating tumor-derived components, such as cell-free DNA (cfDNA), circulating tumor cells (CTCs), cell-free RNAs (cfRNAs), exosomes, tumor-educated platelets (TEPs), proteins, and metabolites in blood or other biofluids can enable early cancer detection, treatment selection, therapy monitoring and prognosis assessment. There have been great advances in liquid biopsy of NSCLC in the past few years. Hence, this chapter introduces the latest advances on the clinical application of cfDNA, CTCs, cfRNAs and exosomes, with a particular focus on their application as early markers in the diagnosis, treatment and prognosis of NSCLC.
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Affiliation(s)
- Xiao-Dong Ren
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Ning Su
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Xian-Ge Sun
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Wen-Man Li
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Jin Li
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Bo-Wen Li
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Ruo-Xu Li
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Jing Lv
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Qian-Ying Xu
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Wei-Long Kong
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China
| | - Qing Huang
- Department of Laboratory Medicine, Daping Hospital, Army Medical University, Chongqing, P.R. China.
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Wan Y, Qian Y, Wang Y, Fang F, Wu G. Prognostic value of Beclin 1, EGFR and ALK in non-squamous non-small cell lung cancer. Discov Oncol 2022; 13:127. [PMID: 36401689 PMCID: PMC9675885 DOI: 10.1007/s12672-022-00586-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/31/2022] [Indexed: 11/21/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) is one of the most malignant tumors. The study was carried out to investigate the prognostic value of Beclin 1, EGFR and ALK for this cancer. Patients diagnosed with non-squamous NSCLC and admitted to our hospital from January 2011 to September 2016 were analyzed. Expression of Beclin 1 and mutation of EGFR and ALK were assessed using polymerase chain reaction (PCR) and fluorescent in situ hybridization (FISH) and analyzed for their relationship with demographic and clinical characteristics of the patients. Multivariate Cox regression models were applied to analyze the risk factors associated with survival and receiver response curves (ROC) were plotted to determine the prognostic value of Beclin 1, EGFR and ALK for patients with non-squamous NSCLC. Compared with adjacent normal tissue, Beclin 1 expression was elevated in the cancer tissue significantly; assessments of EGFR and ALK mutations showed that out of the 480 patients, 233 (48.5%) and 75 (12.6%) patients had EGFR and ALK mutations. Univariate analysis revealed that Beclin 1 level, EGFR and ALK mutations were associated with lymph node metastasis, TNM stage, tumor differentiation and prognosis, but not with gender, age and smoking status. The Kaplan-Meier survival analysis indicated that low Beclin 1 expression and positive EGFR and ALK rearrangements were associated with higher survival rate and longer progress-free survival (PFS). Multivariate Cox regression analysis showed that Beclin 1, EGFR, ALK mutations, tumor differentiation grade, TNM stage and lymph node metastasis were independently associated with PFS. ROC analysis showed that Beclin 1, EGFR and ALK were significant predictors for PFS; the areas under curve (AUC) for Beclin 1, EGFR and ALK were 0.812 (P = 0.018, cut-off value: 1.2), 0.781 (P = 0.011, cut-off value: 15%) and 0.722 (P = 0.010, cut-off value: 11%), respectively, suggesting that they have significant prognostic value for lung cancer patients. Our data indicate that Beclin 1, EGFR and ALK genes are associated with the prognosis of patients with non-squamous NSCLC. High Beclin 1 expression and negative EGFR and ALK mutations predict a poor prognosis with PFS.
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Affiliation(s)
- Yanhui Wan
- Department of Thoracic Surgery, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, 3002 Futian Road , Shenzhen, 518000, China.
| | - Youhui Qian
- Department of Thoracic Surgery, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, 3002 Futian Road , Shenzhen, 518000, China
| | - Youyu Wang
- Department of Thoracic Surgery, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, 3002 Futian Road , Shenzhen, 518000, China
| | - Fuyuan Fang
- Department of Thoracic Surgery, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, 3002 Futian Road , Shenzhen, 518000, China
| | - Guodong Wu
- Department of Thoracic Surgery, the First Affiliated Hospital of Shenzhen University/Shenzhen Second People's Hospital, 3002 Futian Road , Shenzhen, 518000, China
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Okuno M, Mukai T, Iwata K, Watanabe N, Tanaka T, Iwasa T, Shimojo K, Ohashi Y, Takagi A, Ito Y, Tezuka R, Iwata S, Iwasa Y, Kochi T, Ogiso T, Hayashi H, Sugiyama A, Nishigaki Y, Tomita E. Evaluation of the Cell Block Method Using Overnight-Stored Bile for Malignant Biliary Stricture Diagnosis. Cancers (Basel) 2022; 14:cancers14112701. [PMID: 35681681 PMCID: PMC9179241 DOI: 10.3390/cancers14112701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
The specimen collection and subsequent pathological diagnosis of malignant biliary stricture (MBS) are difficult. This study aimed to determine whether the cell block (CB) method using overnight-stored bile is useful in the diagnosis of MBS. This trial was a single-arm prospective study involving a total of 59 patients with suspected MBS. The primary endpoint was cancer detectability and accuracy using the CB method, and a comparison with the detectability and accuracy achieved with bile cytology was made. The immunohistochemical sensitivity for maspin and p53 was also investigated in the CB and surgical specimens. We were able to collect bile from all 59 patients, and 45 of these patients were clinically diagnosed with MBS. The cancer detectability using the CB method (62.2%) was significantly higher than that using cytology (37.8%) (p = 0.0344). When CB was combined with biopsy, the rates of cancer detectability (75.6%) and accuracy (81.4%) increased. In eight patients who received surgical therapy, maspin- and p53-immunohistochemistry was applied to the surgical and CB specimens, and cancer cells in both specimens showed positive cytoplasmic and nuclear staining for maspin and nuclear staining for p53. The CB method is, thus, useful for detecting malignancy (UMIN000034707).
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Affiliation(s)
- Mitsuru Okuno
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
- Correspondence: ; Tel.: +81-58-251-1101
| | - Tsuyoshi Mukai
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
- Department of Gastroenterological Endoscopy, Kanazawa Medical University, Uchinada 920-0293, Japan
| | - Keisuke Iwata
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Naoki Watanabe
- Department of Diagnostic Pathology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (N.W.); (T.T.)
| | - Takuji Tanaka
- Department of Diagnostic Pathology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (N.W.); (T.T.)
| | - Taisei Iwasa
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Kota Shimojo
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Yosuke Ohashi
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Akihiro Takagi
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Yuki Ito
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Ryuichi Tezuka
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Shota Iwata
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Yuhei Iwasa
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Takahiro Kochi
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Tomio Ogiso
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Hideki Hayashi
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Akihiko Sugiyama
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Youichi Nishigaki
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
| | - Eiichi Tomita
- Department of Gastroenterology, Gifu Municipal Hospital, Gifu 500-8513, Japan; (T.M.); (K.I.); (T.I.); (K.S.); (Y.O.); (A.T.); (Y.I.); (R.T.); (S.I.); (Y.I.); (T.K.); (T.O.); (H.H.); (A.S.); (Y.N.); (E.T.)
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Chen X, Li K, Liu Z, Gai F, Zhu G, Lu S, Che N. Multigene PCR using both cfDNA and cfRNA in the supernatant of pleural effusion achieves accurate and rapid detection of mutations and fusions of driver genes in patients with advanced NSCLC. Cancer Med 2021; 10:2286-2292. [PMID: 33656807 PMCID: PMC7982639 DOI: 10.1002/cam4.3769] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/16/2021] [Accepted: 01/21/2021] [Indexed: 01/29/2023] Open
Abstract
Background Pleural effusion from patients with advanced non‐small cell lung cancer (NSCLC) has been proved valuable for molecular analysis, especially when the tissue sample not available. However, simultaneous detection of multiple driver gene alterations especially the fusions is still challenging. Methods In this study, 77 patients with advanced NSCLC and pleural effusion were enrolled, 49 of whom had matched tumor tissues. Supernatants, cell sediments, and cell blocks were prepared from pleural effusion samples for detection of driver alterations by a PCR‐based 9‐gene mutation detection kit. Results Mutations in EGFR, KRAS, and HER2 were detected in DNA and cfDNA, fusions in ALK was detected in RNA and cfRNA. Compared with matched tumor tissue, the supernatant showed the highest overall sensitivity (81.3%), with 81.5% for SNV/Indels by cfDNA and 80% for fusions by cfRNA, followed by cell blocks (71.0%) and the cell sediments (66.7%). Within the group of treatment‐naïve patients or malignant cells observed in the cell sediments, supernatant showed higher overall sensitivity (89.5% and 92.3%) with both 100% for fusions. Conclusions CfDNA and cfRNA derived from pleural effusion supernatant have been successfully tested with a PCR‐based multigene detection kit. Pleural effusion supernatant seems a preferred material for detection of multigene alterations to guide treatment decision of advanced NSCLC.
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Affiliation(s)
- Xuejing Chen
- Department of Pathology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis And Thoracic Tumor Research Institute, Beijing, China
| | - Kun Li
- Department of Pathology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis And Thoracic Tumor Research Institute, Beijing, China
| | - Zichen Liu
- Department of Pathology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis And Thoracic Tumor Research Institute, Beijing, China
| | - Fei Gai
- Medical Department, Amoy Diagnostics Co., Ltd., Xiamen, China
| | - Guanshan Zhu
- Medical Department, Amoy Diagnostics Co., Ltd., Xiamen, China
| | - Shun Lu
- Department of Oncology, Shanghai Chest Hospital Shanghai Jiaotong University, Shanghai, China
| | - Nanying Che
- Department of Pathology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis And Thoracic Tumor Research Institute, Beijing, China
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