| Rina Na,Wei Luan,Yinzai He,Yanwei Gao,Nier Cha,Baoqin Jia. Relationship between molecular changes in epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) mutations in lung adenocarcinoma. Oncol Transl Med, 2021, 7: 155-159. |
| Relationship between molecular changes in epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) mutations in lung adenocarcinoma |
| Received:June 21, 2020 Revised:August 15, 2021 |
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| KeyWord:lung cancer; histological subtypes; prognosis; the echinoderm microtubule-associated protein-like 4 gene-ALK variant (EML4-ALK); epidermal growth factor receptor (EGFR) |
| Author Name | Affiliation | E-mail | | Rina Na | Department of General Surgery, Inner Mongolia People''s Hospital | luan1977@126.com | | Wei Luan | Department of Oncology, Inner Mongolia People''s Hospital | | | Yinzai He | Department of Surgical Oncology, Inner Mongolia People''s Hospital | | | Yanwei Gao | Department of Surgical Oncology, Inner Mongolia People''s Hospital | | | Nier Cha | Department of Surgical Oncology, Inner Mongolia People''s Hospital | | | Baoqin Jia | Department of Surgical Oncology, Inner Mongolia People''s Hospital | 13604715646@qq.com |
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| Abstract: |
| Objective: This study aimed to analyze the relationship between the mutations in epidermal growth factor
receptor (EGFR) and anaplastic lymphoma kinase (ALK) and their impact on the prognosis and treatment
of lung adenocarcinoma.
Methods: A total of 158 cases of lung adenocarcinoma reported between January 2007 and January
2014 were retrospectively analyzed. These tumors were resected using radical pneumonectomy and
underwent pathology-based diagnosis at our institution (Inner Mongolia People’s Hospital, Hohhot, China).
The tissue sections were evaluated using the updated World Health Organization classification of lung
adenocarcinomas (2015 version), with each histological component recorded in 5% increments. The
histological subtypes were classified, and any surviving cases were followed up. The reverse transcriptionpolymerase
chain reaction (RT-PCR) and direct DNA sequencing were used to evaluate mutations in exons
18, 19, 20, and 21 in the EGFR gene, and the echinoderm microtubule-associated protein-like 4 gene-ALK
variant (EML4-ALK) fusions were detected using sequencing.
Results: Our cohort included 25 patients with pre-invasive adenocarcinoma, 13 patients with lepidic, 66
patients with acinar, 13 patients with papillary, and 25 patients with solid infiltrative adenocarcinoma with
the remaining cases presenting with a variety of pathological subtypes. The prognosis of each histological
subtype was different with the 5-year disease-free survival and 5-year overall survival (OS) of pre-invasion
adenocarcinoma at 100%; the 5-year OS of lepidic, acinar, and papillary adenocarcinoma patients was
only 84.6%, 72.7%, and 76.9%, respectively. The 5-year OS of solid and mucinous adenocarcinomas were
32.0% and 36.4%, respectively. EGFR mutation was detected in 69 cases with a mutation rate of 43.7% and
majority of these mutations were found in exons 19 (50.6%) and 21 (37.9%), with women and non-smokers
shown to experience a higher mutation rate (P < 0.05). However, histological subtype analysis showed that
EGFR mutations were primarily found in adenocarcinomas. Most of these mutations were found in lepidic
(53.8%) or acinar adenocarcinomas (50.0%), whereas these mutations were rare in both solid (28.0%) and
mucinous adenocarcinoma (27.2%). The fusion mutation rate in the EML4-ALK gene was 5.69%, and was
most common in young, nonsmoking patients (P < 0.05).
Conclusion: The prognosis of patients in each lung adenocarcinoma subtype is different, and these
outcomes are likely related to mutations in the EGFR and EML4-ALK genes. EGFR mutation rates are
higher in lepidic and acinar adenocarcinomas, whereas EML4-ALK gene fusion mutations are more
common in solid and mucinous adenocarcinoma. EGFR mutations are more common in female and nonsmoking
patients, whereas EML4-ALK fusions are more common in young, non-smoking patients. |
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