Cappuzzo Federico, Marchetti Antonio, Skokan Margaret, Rossi Elisa, Gajapathy Sujatha, Felicioni Lara, Del Grammastro Maela, Sciarrotta Maria Grazia, Buttitta Fiamma, Incarbone Matteo, Toschi Luca, Finocchiaro Giovanna, Destro Annarita, Terracciano Luigi, Roncalli Massimo, Alloisio Marco, Santoro Armando, Varella-Garcia Marileila
Istituto Clinico Humanitas, Istituto di Ricovero e Cura a Carattere Scientifico, Department of Oncology-Hematology, University of Milan School of Medicine, IRCCS Istituto Clinico Humanitas, Rozzano, Italy.
J Clin Oncol. 2009 Apr 1;27(10):1667-74. doi: 10.1200/JCO.2008.19.1635. Epub 2009 Mar 2.
To investigate the prognostic role of genomic gain for MET and epidermal growth factor receptor (EGFR) genes in surgically resected non-small-cell lung cancer (NSCLC).
This retrospective study included 447 NSCLC patients with available tumor tissue from primary lung tumor and survival data. EGFR and MET status was evaluated by fluorescent in situ hybridization (FISH) in tissue microarray sections.
EGFR FISH results were obtained in 376 cases. EGFR gene amplification and high polysomy (EGFR FISH+) were observed in 10.4% and 32.4% of cases, respectively. EGFR FISH-positive patients had a nonsignificant shorter survival than EGFR FISH-negative patients (P = .4). Activating EGFR mutations were detected in 9.7% of 144 stage I-II disease with no impact on survival. MET FISH analysis was performed in 435 cases. High MET gene copy number (mean > or = 5 copies/cell) was observed in 48 cases (MET+, 11.1%), including 18 cases with true gene amplification (4.1%). MET+ status was associated with advanced stage (P = .01), with grade 3 (P = .016) and with EGFR FISH+ result (P < .0001). No patient with activating EGFR mutation resulted MET+. In the whole population, MET-positive patients had shorter survival than MET-negative patients (P = .005). Multivariable model confirmed that MET-negative patients had a significant reduction in the risk of death than MET-positive patients (hazard ratio, 0.66; P = .04).
MET increased gene copy number is an independent negative prognostic factor in surgically resected NSCLC. EGFR gene gain does not impact survival after resection.
探讨MET和表皮生长因子受体(EGFR)基因的基因组扩增在手术切除的非小细胞肺癌(NSCLC)中的预后作用。
这项回顾性研究纳入了447例有原发性肺肿瘤可用肿瘤组织及生存数据的NSCLC患者。通过组织微阵列切片中的荧光原位杂交(FISH)评估EGFR和MET状态。
376例获得了EGFR FISH结果。分别在10.4%和32.4%的病例中观察到EGFR基因扩增和高多体性(EGFR FISH+)。EGFR FISH阳性患者的生存期比EGFR FISH阴性患者略短,但差异无统计学意义(P = 0.4)。在144例I-II期疾病中,9.7%检测到激活型EGFR突变,对生存无影响。对435例进行了MET FISH分析。48例(MET+,11.1%)观察到高MET基因拷贝数(平均≥5拷贝/细胞),其中18例为真正的基因扩增(4.1%)。MET+状态与晚期(P = 0.01)、3级(P = 0.016)以及EGFR FISH+结果相关(P < 0.0001)。没有激活型EGFR突变的患者为MET+。在总体人群中,MET阳性患者的生存期比MET阴性患者短(P = 0.005)。多变量模型证实,MET阴性患者比MET阳性患者的死亡风险显著降低(风险比,0.66;P = 0.04)。
MET基因拷贝数增加是手术切除的NSCLC的独立不良预后因素。EGFR基因扩增对切除后的生存无影响。