Department of General Thoracic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan,
Target Oncol. 2013 Dec;8(4):237-42. doi: 10.1007/s11523-012-0241-x. Epub 2012 Dec 5.
The purpose of this study was to clarify the distribution of epidermal growth factor receptor (EGFR) mutations between primary tumors (PT) and metastatic lymph node (MLN) in patients with resected non-small cell lung cancer (NSCLC) and to identify a better predictive marker of the response to EGFR tyrosine kinase inhibitor (EGFR-TKI). We conducted a retrospective review of the data of 70 lung cancer patients with lymph node metastasis who underwent surgical resection. Analysis to detect EGFR mutations was performed by a peptide nucleic acid-locked nucleic acid polymerase chain reaction clamp method. EGFR mutations were detected in 15.7 % of both the PT and MLN and in 14.3 % of the PT only. The response rate to EGFR-TKI tended to be higher in patients with EGFR mutations in the MLN, as all patients with EGFR mutations in the MLN showed disease control to treatment with EGFR-TKI. Our results demonstrated that the EGFR mutation status of MLN is a predictive marker of the response to EGFR-TKI therapy in patients with recurrent NSCLC after surgical resection.
本研究旨在阐明接受手术切除的非小细胞肺癌（NSCLC）患者的原发肿瘤（PT）和转移淋巴结（MLN）中表皮生长因子受体（EGFR）突变的分布，并确定更好的预测 EGFR 酪氨酸激酶抑制剂（EGFR-TKI）反应的标志物。我们对 70 例接受淋巴结清扫术的肺癌伴淋巴结转移患者的数据进行了回顾性分析。通过肽核酸-锁核酸聚合酶链反应夹心法进行 EGFR 突变分析。PT 和 MLN 中均有 15.7%，PT 中仅 14.3%检测到 EGFR 突变。MLN 中存在 EGFR 突变的患者对 EGFR-TKI 的反应率较高，因为所有 MLN 中存在 EGFR 突变的患者均对 EGFR-TKI 治疗显示出疾病控制。我们的结果表明，MLN 中的 EGFR 突变状态是手术切除后复发性 NSCLC 患者对 EGFR-TKI 治疗反应的预测标志物。
