PIK3CA mutations frequently coexist with EGFR/KRAS mutations in non-small cell lung cancer and suggest poor prognosis in EGFR/KRAS wildtype subgroup.

PIK3CA mutations frequently coexist with EGFR/KRAS mutations in non-small cell lung cancer and suggest poor prognosis in EGFR/KRAS wildtype subgroup.
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在非小细胞肺癌中,PIK3CA 突变经常与 EGFR/KRAS 突变共存,提示 EGFR/KRAS 野生型亚组预后不良。

DOI:
10.1371/journal.pone.0088291
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发表时间:
2014
期刊:
影响因子:
3.7
通讯作者:
Chen H
Chen H
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Wang L;Hu H;Pan Y;Wang R;Li Y;Shen L;Yu Y;Li H;Cai D;Sun Y;Chen H

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编码磷脂酰肌醇-3-激酶(PI3K)的催化亚基的PIK3CA基因在各种瘤形成(包括肺癌)中突变和/或扩增。本文研究了PIK3CA基因的改变、PI3K通路核心组分的表达及其在非小细胞肺癌(NSCLC)中的临床意义。在1117例NSCLC患者的肿瘤中检测到PIK3CA、EGFR、KRAS、HER2、BRAF、AKT1和ALK基因的致癌突变/重排。采用荧光原位杂交法检测PIK3CA基因突变患者和108例非突变患者的PIK3CA基因拷贝数,免疫组化法检测PIK3CA突变患者和非突变患者的PI3K p110 α亚单位(PI3K p110 α)、p-Akt、mTOR、PTEN的表达。 PIK3CA基因突变在鳞癌和腺癌中的检出率分别为3.9%和2.7%。在34例PIK3CA突变病例中,17例肿瘤同时存在EGFR突变,4例存在KRAS突变。PIK3CA突变与PI3K p110 α(p <0.0001)、p-Akt(p = 0.024)和mTOR(p = 0.001)的高表达显著相关,但与PIK3CA扩增无关(p = 0.463)。      具有单一PIK3CA突变的患者的总生存期短于具有PIK3CA-EGFR/KRAS共突变或野生型PIK3CA的患者(p = 0.004)。  在EGFR/KRAS野生型亚组中,还发现PIK3CA突变患者的生存率显著低于无PIK3CA突变的患者(p = 0.043)。PIK3CA突变经常与EGFR/KRAS突变共存。  PIK3CA单突变患者预后差,PIK3CA突变在EGFR/KRAS野生型亚组中的预后价值表明,应确定PIK3CA基因的不同突变状态,以制定NSCLC的个体化治疗策略。
PIK3CA gene encoding a catalytic subunit of the phosphatidylinositol-3-kinase (PI3K) is mutated and/or amplified in various neoplasia, including lung cancer. Here we investigated PIK3CA gene alterations, the expression of core components of PI3K pathway, and evaluated their clinical importance in non-small cell lung cancer (NSCLC). Oncogenic mutations/rearrangements in PIK3CA, EGFR, KRAS, HER2, BRAF, AKT1 and ALK genes were detected in tumors from 1117 patients with NSCLC. PIK3CA gene copy number was examined by fluorescent in situ hybridization and the expression of PI3K p110 subunit alpha (PI3K p110α), p-Akt, mTOR, PTEN was determined by immunohistochemistry in PIK3CA mutant cases and 108 patients without PIK3CA mutation. PIK3CA mutation was found in 3.9% of squamous cell carcinoma and 2.7% of adenocarcinoma. Among 34 PIK3CA mutant cases, 17 tumors harbored concurrent EGFR mutations and 4 had KRAS mutations. PIK3CA mutation was significantly associated with high expression of PI3K p110α (p<0.0001), p-Akt (p = 0.024) and mTOR (p = 0.001), but not correlated with PIK3CA amplification (p = 0.463). Patients with single PIK3CA mutation had shorter overall survival than those with PIK3CA-EGFR/KRAS co-mutation or wildtype PIK3CA (p = 0.004). A significantly worse survival was also found in patients with PIK3CA mutations than those without PIK3CA mutations in the EGFR/KRAS wildtype subgroup (p = 0.043) PIK3CA mutations frequently coexist with EGFR/KRAS mutations. The poor prognosis of patients with single PIK3CA mutation in NSCLC and the prognostic value of PIK3CA mutation in EGFR/KRAS wildtype subgroup suggest the distinct mutation status of PIK3CA gene should be determined for individual therapeutic strategies in NSCLC.
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发表时间: 2011
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影响因子: 3.7
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