Clinical Significance of Detecting Somatic Gene Mutations in Surgically Resected Adenosquamous Cell Carcinoma of the Lung in Japanese Patients
Clinical Significance of Detecting Somatic Gene Mutations in Surgically Resected Adenosquamous Cell Carcinoma of the Lung in Japanese Patients
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DOI：
10.1245/s10434-014-4218-0
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发表时间：
2015-08-01
影响因子：
3.7
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
--
作者：
Morodomi, Yosuke;Okamoto, Tatsuro;Maehara, Yoshihiko
表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）和棘皮动物微管相关蛋白样4-间变性淋巴瘤激酶（EML 4-ALK）抑制剂是治疗携带EGFR-TKI敏感性突变或EML 4-ALK重排患者的有效和有用药物。因此，在治疗肺腺癌时确定这些体细胞突变的存在的重要性被广泛接受。然而，肺腺鳞状细胞癌（一种相对罕见的肺癌组织学类型）患者很少评估基因突变，因为对这些患者评估这些致癌突变的知识有限且价值不明确。因此，我们调查了日本患者手术切除的肺腺鳞癌中体细胞突变的临床意义，我们回顾性分析了32例在日本两个研究所接受手术切除的肺腺鳞癌患者。对所有患者的EGFR突变和EML 4-ALK重排进行了评估。总体而言，32例患者中有7例（21.9%）存在EGFR突变：3例患者存在外显子19缺失，4例患者存在外显子21，L 858 R突变。没有T790 M突变。总队列的中位无复发生存期为766天，中位总生存期为1，152天。无复发生存率和总生存率在EGFR突变和无EGFR突变的患者之间没有显著差异。检测腺鳞癌患者的EGFR突变具有临床重要性，尤其是在疾病复发的患者中，因为EGFR-TKI可能对这种组织学类型的肺癌有效。
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) inhibitors are effective and useful agents for treating patients who harbor EGFR-TKI-sensitive mutations or EML4-ALK rearrangement. Therefore, the importance of determining the presence of these somatic mutations when treating lung adenocarcinomas is widely accepted. However, genetic mutations are rarely evaluated in patients with adenosquamous cell carcinoma of the lung, a relatively infrequent histologic type of lung cancer, because of limited knowledge and the unclear value of assessing these oncogenic mutations in these patients. Therefore, we investigated the clinical implications of somatic mutations in surgically resected adenosquamous cell carcinoma of the lung in Japanese patients.We retrospectively analyzed 32 patients with adenosquamous cell carcinoma of the lung who underwent surgical resection at two institutes in Japan. EGFR mutations and EML4-ALK rearrangement were assessed in all of the patients.Overall, 7 (21.9 %) of 32 patients had EGFR mutations: three patients had an exon 19 deletion and 4 had an exon 21, L858R mutation. There were no T790 M mutations. The median relapse-free survival was 766 days and the median overall survival was 1,152 days in the total cohort. Relapse-free survival and overall survival were not significantly different between patients with or without EGFR mutations.Detecting EGFR mutations in patients with adenosquamous cell carcinoma is clinically important, especially in patients with disease recurrence because EGFR-TKIs may be effective in this histologic type of lung cancer.