Tran Thang N, Selinger Christina I, Kohonen-Corish Maija R J, McCaughan Brian, Kennedy Catherine, O'Toole Sandra A, Cooper Wendy A
Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Kinghorn Cancer Centre and Garvan Institute of Medical Research, Darlinghurst, Sydney, New South Wales, Australia; School of Medicine, University of Western Sydney, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, New South Wales, Australia.
Clin Lung Cancer. 2016 Jan;17(1):30-8.e1. doi: 10.1016/j.cllc.2015.08.002. Epub 2015 Aug 18.
Mesenchymal epithelial transition factor (MET) is a promising therapeutic target in non-small-cell lung cancer (NSCLC) but there are limited data about MET alterations in treatment-naive NSCLC and whether or not these changes are consistent between primary tumors and metastases. We aimed to investigate concordance, clinicopathological correlations, and prognostic value of MET alterations in primary NSCLC and corresponding nodal metastases.
MET gene copy number (GCN) status was evaluated using fluorescent in situ hybridization (FISH) and MET protein expression using immunohistochemistry (IHC) in tissue microarray sections from a retrospective cohort of 300 surgically resected NSCLCs including 93 cases with nodal metastases.
Primary NSCLCs were MET IHC positive in 28 (10.3%) of cases and MET FISH positive (high polysomy or amplification) in 22 (8.1%) but only 1 (0.4%) showed amplification. In metastases, high MET GCN (18.3%) and protein expression (21.3%) was more frequent compared with primary tumors. The status of MET in lymph nodes significantly correlated with MET status in the corresponding primary tumors. Squamous cell carcinomas showed lower MET overexpression compared with nonsquamous tumors but there were no other associations with clinicopathological characteristics. Patients with tumors that were either MET FISH positive or IHC positive had a significantly better overall survival in univariate and multivariate analyses.
Alterations of MET are more commonly seen in nodal metastases than primary tumors and this might have implications for their utility as predictive biomarkers to select patients for MET inhibition. MET overexpression and MET high polysomy occur in a low proportion of primary NSCLCs and is associated with a good prognosis.
间充质上皮转化因子(MET)是非小细胞肺癌(NSCLC)中一个很有前景的治疗靶点,但关于未经治疗的NSCLC中MET改变的数据有限,以及这些改变在原发性肿瘤和转移灶之间是否一致也不清楚。我们旨在研究原发性NSCLC及其相应淋巴结转移灶中MET改变的一致性、临床病理相关性及预后价值。
在一个回顾性队列研究中,对300例手术切除的NSCLC(包括93例有淋巴结转移的病例)的组织芯片切片,采用荧光原位杂交(FISH)评估MET基因拷贝数(GCN)状态,采用免疫组织化学(IHC)评估MET蛋白表达。
原发性NSCLC中,28例(10.3%)MET IHC阳性,22例(8.1%)MET FISH阳性(高多体性或扩增),但只有1例(0.4%)显示扩增。在转移灶中,与原发性肿瘤相比,MET高GCN(18.3%)和蛋白表达(21.3%)更常见。淋巴结中MET状态与相应原发性肿瘤中的MET状态显著相关。与非鳞状肿瘤相比,鳞状细胞癌的MET过表达较低,但与其他临床病理特征无其他关联。在单因素和多因素分析中,MET FISH阳性或IHC阳性的肿瘤患者总生存期显著更好。
MET改变在淋巴结转移灶中比原发性肿瘤中更常见,这可能对其作为预测生物标志物来选择接受MET抑制治疗的患者的效用有影响。MET过表达和MET高多体性在原发性NSCLC中发生率较低,且与良好预后相关。