Non-BAC component but not epidermal growth factor receptor gene mutation is associated with poor outcomes in small adenocarcinoma of the lung
Non-BAC component but not epidermal growth factor receptor gene mutation is associated with poor outcomes in small adenocarcinoma of the lung
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DOI：
10.1097/jto.0b013e31817c6080
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发表时间：
2008-07-01
影响因子：
20.4
通讯作者：
Date, Hiroshi
中科院分区：
文献类型：
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作者：
Kobayashi, Naruyuki;Toyooka, Shinichi;Date, Hiroshi
目的：本研究的目的是确定小肺腺癌手术切除后临床预后不良的危险因素。材料与方法：回顾性分析127例经肺叶切除术合并纵隔淋巴结清扫的IA期20mm及以下肺腺癌患者的临床资料。客观量化非细支气管肺泡癌（non-细支气管肺泡癌，non-BAC）成分的百分比，并通过基于聚合酶链反应的检测确定表皮生长因子受体基因（EGFR）突变，回顾性地与临床数据相关联。结果：根据非BAC成分的百分比，127例患者分为：I组26例为BAC， II组46例为>= 50% BAC的混合亚型，III组18例为BAC低于50%的混合亚型，IV组37例为所有非BAC成分或纯非BAC成分之一的混合亚型。第1组和第2组被认为是“低非bac成分类型”，第3组和第4组被认为是“高非bac成分类型”。64例（50.4%）患者外显子19和外显子21发生EGFR突变。在复发方面，高非bac成分类型是复发的唯一独立因素（p = 0.029）。生存率方面，高年龄（p = 0.028）和高非bac成分类型（p = 0.046）是总生存率差的独立危险因素。它们也是无病生存差的独立危险因素（p = 0.025和p = 0.027分别）。结论：高非bac成分而非EGFR突变状态是IA期肺腺癌患者复发和预后不良的独立危险因素
Objective: The purpose of this study was to identify risk factors for poor clinical outcome after surgical resection of small lung adenocarcinoma.Materials and Methods: Clinical records of 127 patients who had pathologic stage IA lung adenocarcinoma 20 mm or less and who had undergone a lobectomy with mediastinal lymph node dissection were reviewed. The percentage of non-bronchioloalveolar carcinoma (non-BAC) components quantified objectively, and epidermal growth factor receptor gene (EGFR) mutation determined by polymerase chain reaction-based assay were retrospectively linked with clinical data.Results: Based on the percentage of non-BAC component, 127 patients were classified as follows: 26 in group I, BAC, 46 in group II mixed subtype with >= 50% BAC, 18 in group III, mixed subtype with under 50% BAC, and 37 in group IV, mixed subtype with all non-BAC components or a pure pattern of one of the non-BAC components. Groups I and II were considered to be a "low non-BAC component type" and groups III and IV were considered to be a "high non-BAC component type." EGFR mutations in exon19 and exon21 were observed in 64 patients (50.4%). In terms of recurrence, the high non-BAC component type was the only independent factor for recurrence (p = 0.029). Regarding survival, the high age (p = 0.028) and high non-BAC component type (p = 0.046) were independent risk factors for poor overall survival. They were also independent risk factors for poor disease-free survival (p = 0.025 and p = 0.027, respectively).Conclusion: The high non-BAC component but not EGFR mutation status, is an independent risk factor for both recurrence and poor prognosis in patients with stage IA lung adenocarcinoma