Lu Hong-Yang, Mao Wei-Min, Cheng Qiao-Yuan, Chen Bo, Cai Ju-Fen, Wang Xiao-Jia, Wang Zeng, Xie Fa-Jun
Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology (esophagus, lung), Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022.
Oncol Lett. 2012 Jun;3(6):1288-1292. doi: 10.3892/ol.2012.666. Epub 2012 Apr 2.
The mutation status of epidermal growth factor receptor (EGFR) is correlated with the response of tumors to EGFR tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC), suggesting its usefulness as a biomarker in NSCLC. The incidence of EGFR mutation in NSCLC is higher in China than in the United States and European countries. There have been some case reports concerning cases of gefitinib-responsive small cell lung cancer (SCLC) with EGFR mutations. However, few large studies concerning the mutation status of SCLC patients have been performed. We detected EGFR mutations in exons 19 and 21 of 40 SCLC patients, three of whom had combined SCLC, from the Zhejiang Cancer Hospital using xTAG technology. Only two patients with combined SCLC had an EGFR mutation in exon 19. To determine the EGFR mutation status and clinical features of combined SCLC, we retrospectively analyzed the clinical features of seven patients with combined SCLC who had undergone surgical treatment in Zhejiang Cancer Hospital between 2007 and 2010. EGFR mutations in exons 19 and 21 were detected using the pyrosequencing assay. Of the seven patients with combined SCLCs, 71.4% were male, 71.4% were heavy smokers, most were over 60 years old and 71.4% of the cases were combined adenocarcinoma. Chemotherapy treatment and tumor stage were correlated with survival time. Of the seven cases, one had a mutation in exon 19 of EGFR in both the conventional SCLC and SCLC combined adenocarcinoma components. Combined SCLC commonly occurs in patients who are heavy smokers, male and over 60 years old, and most of the combined type cases are adenocarcinoma. The treatment of combined SCLC may be applied to cases of conventional SCLC. EGFR mutations may therefore occur in combined SCLCs, especially in SCLC combined adenocarcinoma in China.
表皮生长因子受体（EGFR）的突变状态与非小细胞肺癌（NSCLC）中肿瘤对EGFR酪氨酸激酶抑制剂的反应相关，提示其作为NSCLC生物标志物的有用性。中国NSCLC中EGFR突变的发生率高于美国和欧洲国家。已有一些关于吉非替尼敏感的EGFR突变小细胞肺癌（SCLC）病例的报道。然而，针对SCLC患者突变状态的大型研究较少。我们使用xTAG技术检测了浙江省肿瘤医院40例SCLC患者（其中3例为合并性SCLC）外显子19和21的EGFR突变。仅2例合并性SCLC患者外显子19有EGFR突变。为确定合并性SCLC的EGFR突变状态和临床特征，我们回顾性分析了2007年至2010年在浙江省肿瘤医院接受手术治疗的7例合并性SCLC患者的临床特征。使用焦磷酸测序法检测外显子19和21的EGFR突变。在7例合并性SCLC患者中，71.4%为男性，71.4%为重度吸烟者，大多数年龄超过60岁，71.4%的病例为合并腺癌。化疗治疗和肿瘤分期与生存时间相关。在这7例病例中，1例在传统SCLC和SCLC合并腺癌成分中EGFR外显子19均有突变。合并性SCLC常见于重度吸烟、男性且年龄超过60岁的患者，且大多数合并类型病例为腺癌。合并性SCLC的治疗可能适用于传统SCLC病例。因此，EGFR突变可能发生在合并性SCLC中，尤其是在中国的SCLC合并腺癌中。
