Prediction of postoperative recurrences by gene expression profiling in patients with primary resected lung cancer

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We analyzed LCNEC gene expression, gene mutation and immunohistochemical expression of known molecular targets and compared expression to that of lung adenocarcinomas. We analyzed 13 patients with primary LCNEC and 14 patients with adenocarcinoma(AC). We evaluated immunohistochemical(IHC) expression for c-KIT, human epidermal growth factor receptor type 2(HER2), and vascular endothelial growth factor(VEGF), gene mutation for EGFR, K-ras and c-kit, and gene expression using fluorescence in situ hybridization(FISH) for EGFR. In cases with LCNEC, the IHC expression of c-KIT, HER2, and VEGF were 76.9%, 30.8%, and 100%, respectively. There was a significant difference in IHC expression in c-KIT and HER2 between LCNEC and AC. Two cases of LCNEC had overexpression of HER2, and EGFR gene mutation was greater in the AC group, with only a single EGFR mutation(exon 18) identified in the LCNEC group. Although LCNEC had a higher rate of expression of c-KIT by IHC, no c-kit gene mutations were found. These findings suggest a potential role for Anti-VEGF, Anti-c-KIT, and possibly Anti-HER2 targeted agents in the treatment of LCNEC.