Zhang Lan-Jun, Cai Ling, Li Zhe, Wang Wu-Ping, Guo Kang, Shao Jian-Yong, Wang Jun-Ye, Yu Hui, Rong Tie-Hua
Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangdong, People's Republic of China.
Chin J Cancer. 2012 Oct;31(10):491-9. doi: 10.5732/cjc.011.10409. Epub 2012 May 8.
Epidermal growth factor receptor (EGFR) gene mutation and copy number are useful predictive markers that guide the selection of non-small cell lung cancer (NSCLC) patients for EGFR-targeting therapy. This study aimed to investigate the correlation between EGFR gene mutation and copy number and clinicopathologic characteristics of Chinese patients with NSCLC. NSCLC specimens collected from 205 patients between November 2009 and January 2011 were selected to detect EGFR gene mutations with real-time polymerase chain reaction (RT-PCR) and to detect EGFR gene copy number with fluorescence in situ hybridization (FISH). EGFR mutations primarily occurred in females, non-smokers, and patients with adenocarinomas (all P < 0.001). Tissues from 128 (62%) patients were FISH-positive for EGFR, including 37 (18%) with gene amplification and 91 (44%) with high polysomy. EGFR gene mutation was correlated with FISH-positive status (R = 0.340, P < 0.001). Multivariate analysis showed that not smoking (OR = 5.910, 95% CI = 2.363-14.779, P < 0.001) and having adenocarcinoma (OR = 0.122, 95% CI = 0.026-0.581, P = 0.008) were favorable factors for EGFR gene mutation. These results show a high frequency of EGFR FISH positivity in NSCLC tissues from Chinese patients and a significant relevance between EGFR gene mutations and FISH-positive status. Among the FISH-positive samples, EGFR gene mutation occurred more frequently in samples with gene amplification compared to those with high polysomy, suggesting that EGFR mutation and gene amplification should be used as clinical decision parameters to predict response to EGFR-targeting therapy.
表皮生长因子受体(EGFR)基因突变和拷贝数是有用的预测标志物,可指导非小细胞肺癌(NSCLC)患者选择EGFR靶向治疗。本研究旨在探讨EGFR基因突变和拷贝数与中国NSCLC患者临床病理特征之间的相关性。选取2009年11月至2011年1月期间收集的205例NSCLC患者的标本,采用实时聚合酶链反应(RT-PCR)检测EGFR基因突变,采用荧光原位杂交(FISH)检测EGFR基因拷贝数。EGFR突变主要发生在女性、非吸烟者和腺癌患者中(所有P<0.001)。128例(62%)患者的组织FISH检测EGFR呈阳性,其中37例(18%)有基因扩增,91例(44%)有高多倍体。EGFR基因突变与FISH阳性状态相关(R=0.340,P<0.001)。多因素分析显示,不吸烟(OR=5.910,95%CI=2.363-14.779,P<0.001)和患有腺癌(OR=0.122,95%CI=0.026-0.581,P=0.008)是EGFR基因突变的有利因素。这些结果表明,中国患者NSCLC组织中EGFR FISH阳性率较高,且EGFR基因突变与FISH阳性状态之间存在显著相关性。在FISH阳性样本中,与高多倍体样本相比,基因扩增样本中EGFR基因突变更频繁,提示EGFR突变和基因扩增应作为预测EGFR靶向治疗反应的临床决策参数。