Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Clin Lung Cancer. 2013 Sep;14(5):521-6. doi: 10.1016/j.cllc.2013.04.005. Epub 2013 Jun 17.
Epidermal growth factor receptor mutations are predictive of the success of EGFR tyrosine kinase inhibitor treatment in patients with advanced non--small-cell lung cancer. As with other solid tumors, lung cancer is thought to be the result of an accumulation of genetic alterations after exposure to carcinogens. The aim of the present study was to clarify the relationship between multistep carcinogenesis and the accumulation of EGFR mutations.
The intratumor heterogeneity of EGFR mutations was analyzed in 38 patients with resected mixed-type lung adenocarcinoma according to histological patterns, and the clinical features of the patients harboring intratumor heterogeneity of EGFR mutations were evaluated.
Intratumor heterogeneity of EGFR mutations was detected in 9 of 38 tumors. EGFR mutations were more common in the bronchioloalveolar (lepidic) carcinoma pattern than in the papillary and acinar patterns, although this difference was not significant. However, there was a significant correlation between intratumor heterogeneity of EGFR mutations and smoking history (P < .043).
Intratumor heterogeneity of EGFR mutations correlates with the distribution of histological subtype in mixed type adenocarcinoma and is associated with smoking history.
表皮生长因子受体突变可预测晚期非小细胞肺癌患者表皮生长因子受体酪氨酸激酶抑制剂治疗的疗效。与其他实体瘤一样，肺癌被认为是暴露于致癌物后遗传改变积累的结果。本研究旨在阐明多步致癌作用与表皮生长因子受体突变积累之间的关系。
根据组织学模式分析了 38 例切除的混合性肺腺癌患者肿瘤内表皮生长因子受体突变的异质性，并评估了携带肿瘤内表皮生长因子受体突变异质性的患者的临床特征。
在 38 个肿瘤中有 9 个检测到表皮生长因子受体突变的肿瘤内异质性。虽然在支气管肺泡（苔状）癌模式中表皮生长因子受体突变更为常见，但与乳头和腺泡模式相比，差异无统计学意义。然而，表皮生长因子受体突变的肿瘤内异质性与吸烟史之间存在显著相关性（P <.043）。
表皮生长因子受体突变的肿瘤内异质性与混合性腺癌组织学亚型的分布相关，并且与吸烟史有关。
