Oncogenic mutations are associated with histological subtypes but do not have an independent prognostic value in lung adenocarcinoma

	Oncogenic mutations are associated with histological subtypes but do not have an independent prognostic value in lung adenocarcinoma
	Hu, HC; Pan, YJ; Li, Y; Wang, L; Wang, R; Zhang, Y; Li, H; Ye, T; Zhang, YL; Luo, XY
刊名	ONCOTARGETS AND THERAPY
	2014
卷号	7 期号:1 页码:1423-1437
关键词	oncogenic mutation IASLC/ATS/ERS classification personalized treatment molecular testing prognosis
通讯作者	Chen, HQ (reprint author), Fudan Univ, Shanghai Med Coll, Shanghai Canc Ctr, Dept Oncol,Dept Thorac Surg, 270 Dong An Rd, Shanghai 200433, Peoples R China.,sun_yihua76@hotmail.com ; hqchen1@yahoo.com
英文摘要	Lung adenocarcinomas have diverse genetic and morphological backgrounds and are usually classified according to their distinct oncogenic mutations (or so-called driver mutations) and histological subtypes (the de novo classification proposed by the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society [IASLC/ATS/ERS]). Although both these classifications are essential for personalized treatment, their integrated clinical effect remains unclear. Therefore, we analyzed 981 lung adenocarcinomas to detect the potential correlation and combined effect of oncogenic mutations and histological subtype on prognosis. Analysis for oncogenic mutations included the direct sequencing of EGFR, KRAS, HER2, BRAF, PIK3CA, ALK, and RET for oncogenic mutations/rearrangements, and a rereview of the IASLC/ATS/ERS classification was undertaken. Eligible tumors included 13 atypical adenomatous hyperplasia/adenocarcinoma in situ, 20 minimally invasive adenocarcinomas, 901 invasive adenocarcinomas, 44 invasive mucinous adenocarcinomas, and three other variants. The invasive mucinous adenocarcinomas had a lower prevalence of EGFR mutations but a higher prevalence of KRAS, ALK, and HER2 mutations than invasive adenocarcinomas. Smoking, a solid predominant pattern, and a mucinous component were independently associated with fewer EGFR mutations. The ALK rearrangements were more frequently observed in tumors with a minor mucinous component, while the KRAS mutations were more prevalent in smokers. In addition, 503 patients with stage I-IIIA tumors were analyzed for overall survival (OS) and relapse-free survival. The stage and histological pattern were independent predictors of relapse-free survival, and the pathological stage was the only independent predictor for the OS. Although patients with the EGFR mutations had better OS than those without the mutations, no oncogenic mutation was an independent predictor of survival. Oncogenic mutations were associated with the novel IASLC/ATS/ERS classification, which facilitates a morphology-based mutational analysis strategy. The combination of these two classifications might not increase the prognostic ability, but it provides essential information for personalized treatment.
学科主题	Biotechnology & Applied Microbiology; Oncology
类目[WOS]	Biotechnology & Applied Microbiology ; Oncology
关键词[WOS]	INTERNATIONAL-ASSOCIATION ; NEVER-SMOKERS ; DRIVER MUTATIONS ; EGFR MUTATIONS ; GENE-MUTATIONS ; RECEPTOR GENE ; CANCER ; CLASSIFICATION ; CHEMOTHERAPY ; GEFITINIB
收录类别	SCI
语种	英语
WOS记录号	WOS:000340180300002
内容类型	期刊论文
版本	出版稿
源URL	[http://202.127.25.143/handle/331003/309]
专题	上海生化细胞研究所_上海生科院生化细胞研究所
推荐引用方式 GB/T 7714	Hu, HC,Pan, YJ,Li, Y,et al. Oncogenic mutations are associated with histological subtypes but do not have an independent prognostic value in lung adenocarcinoma[J]. ONCOTARGETS AND THERAPY,2014,7(1):1423-1437.
APA	Hu, HC.,Pan, YJ.,Li, Y.,Wang, L.,Wang, R.,...&Chen, HQ.(2014).Oncogenic mutations are associated with histological subtypes but do not have an independent prognostic value in lung adenocarcinoma.ONCOTARGETS AND THERAPY,7(1),1423-1437.
MLA	Hu, HC,et al."Oncogenic mutations are associated with histological subtypes but do not have an independent prognostic value in lung adenocarcinoma".ONCOTARGETS AND THERAPY 7.1(2014):1423-1437.