Department of Urology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China.
Virchows Arch. 2014 May;464(5):575-81. doi: 10.1007/s00428-014-1566-x. Epub 2014 Mar 5.
Activating mutations of the epidermal growth factor receptor (EGFR) confers sensitivity to tyrosine kinase inhibitors (TKIs). In colorectal cancer and in lung adenocarcinomas, clinical trials have shown a lack of response to anti-EGFR therapy when KRAS gene mutations are present. In this study, the mutation status of specified exons of the EGFR and KRAS genes was profiled in patients with prostate cancer (PCa). Direct Sanger sequencing was used to screen for mutations in exons 19-21 of EGFR and in exon 2 of KRAS in 88 Chinese patients diagnosed with prostate adenocarcinomas. Mutations were detected in 11 patients. In nine cases (10 %), activating mutations in the region of EGFR encoding the tyrosine kinase (TK) domain were present. Deletions in exon 19 and the L858R substitution in exon 21 were "hotspot" mutations, together accounting for five (55 %) of nine cases. Many synonymous substitutions were also detected. KRAS mutations were found in two cases (2.3 % of 88). There were no cases with mutations in both EGFR and KRAS, suggesting that mutations in the two genes might be mutually exclusive. Although prognostic relevance of EGFR expression by immunohistochemistry (IHC) was observed in PCa patients in previous studies, we found no statistically significant association between EGFR or KRAS mutations and clinicopathological features (including age, smoking status, preoperative prostate-specific antigen, Gleason scores, and tumor stage). We contend that accurate profiling of the mutation status of EGFR and KRAS could improve prognostic stratification, and we suggest a potential anti-EGFR therapy for patients with PCa with EGFR mutations.
表皮生长因子受体 (EGFR) 的激活突变赋予对酪氨酸激酶抑制剂 (TKI) 的敏感性。在结直肠癌和肺腺癌中,临床试验表明当 KRAS 基因突变存在时,抗 EGFR 治疗没有反应。在这项研究中,对前列腺癌 (PCa) 患者的 EGFR 和 KRAS 基因特定外显子的突变状态进行了分析。使用直接 Sanger 测序筛选 88 例前列腺腺癌患者 EGFR 外显子 19-21 和 KRAS 外显子 2 中的突变。在 11 例患者中检测到突变。在 9 例(10%)中,存在编码酪氨酸激酶(TK)结构域的 EGFR 区域的激活突变。外显子 19 的缺失和外显子 21 的 L858R 取代是“热点”突变,共占 9 例中的 5 例(55%)。还检测到许多同义取代。在 2 例(2.3%的 88 例)中发现 KRAS 突变。没有 EGFR 和 KRAS 均突变的病例,表明这两个基因的突变可能是相互排斥的。尽管在以前的研究中已经观察到 EGFR 表达的免疫组织化学(IHC)与 PCa 患者的预后相关,但我们没有发现 EGFR 或 KRAS 突变与临床病理特征(包括年龄、吸烟状态、术前前列腺特异性抗原、Gleason 评分和肿瘤分期)之间存在统计学显著关联。我们认为准确分析 EGFR 和 KRAS 的突变状态可以改善预后分层,并建议对 EGFR 突变的 PCa 患者进行潜在的抗 EGFR 治疗。