Division of Thoracic Surgery, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.
Respirology. 2010 May;15(4):700-5. doi: 10.1111/j.1440-1843.2010.01746.x. Epub 2010 Mar 29.
Epidermal growth factor receptor (EGFR) mutations are common in lung adenocarcinomas of Asian patients, implying a good response to treatment with the EGFR tyrosine kinase inhibitors, gefitinib and erlotinib. However, the distinct chromosomal imbalances between lung adenocarcinomas with and those without EGFR mutations have not been fully elucidated.
Seventy-seven patients of surgically resected lung adenocarcinoma were analysed for the EGFR exon 19 deletion and the L858R mutation, using mutant-enriched PCR, and for chromosomal imbalance alterations using comparative genomic hybridization.
EGFR mutations were detected in 42 (54.5%) patients, including 22 with the exon 19 deletion and 20 with the L858R mutation. The mean number of chromosomal arms with imbalance alterations was significantly higher in tumours with EGFR mutations than in those lacking these two mutations. The minimal regions with gain on 1q23-q31, 6p12-p21.1 and 7q11.2, and loss on 3p21, 8p22-p23, 9q33, 10q25 and 13q13, differed significantly between lung adenocarcinomas with or without EGFR mutations. However, neither EGFR mutations, nor any of the common chromosomal imbalance alterations alone, exhibited significant associations with tumour stage or disease-specific survival of the patients.
These results indicate that imbalance alterations at several chromosomal regions occur significantly more frequently in lung adenocarcinomas with EGFR mutations than in those without such mutations. Tumour growth-related genes in these chromosomal regions should be further investigated to improve our understanding of the common genetic alterations in lung adenocarcinomas with EGFR mutations.
表皮生长因子受体(EGFR)突变在亚洲肺腺癌患者中很常见,这意味着对 EGFR 酪氨酸激酶抑制剂(如吉非替尼和厄洛替尼)的治疗反应良好。然而,具有 EGFR 突变和不具有 EGFR 突变的肺腺癌之间的明显染色体失衡尚未完全阐明。
采用突变富集 PCR 法检测 77 例手术切除的肺腺癌患者的 EGFR 外显子 19 缺失和 L858R 突变,并采用比较基因组杂交技术检测染色体失衡改变。
在 42 例(54.5%)患者中检测到 EGFR 突变,其中 22 例为外显子 19 缺失,20 例为 L858R 突变。具有 EGFR 突变的肿瘤中染色体臂失衡改变的平均数目明显高于缺乏这两种突变的肿瘤。在 EGFR 突变的肺腺癌中,1q23-q31、6p12-p21.1 和 7q11.2 上获得的最小区域以及 3p21、8p22-p23、9q33、10q25 和 13q13 上缺失的最小区域有显著差异。然而,无论是 EGFR 突变,还是任何常见的染色体失衡改变,都与患者的肿瘤分期或疾病特异性生存没有显著相关性。
这些结果表明,在具有 EGFR 突变的肺腺癌中,与不具有 EGFR 突变的肺腺癌相比,多个染色体区域的失衡改变发生的频率显著更高。这些染色体区域中的肿瘤生长相关基因应进一步研究,以提高我们对具有 EGFR 突变的肺腺癌中常见遗传改变的理解。