完全切除的原发性肺神经内分泌癌的分子特征与生存情况
Molecular Profiling and Survival of Completely Resected Primary Pulmonary Neuroendocrine Carcinoma.
作者信息
Lou Guangyuan, Yu Xinmin, Song Zhengbo
机构信息
Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China; Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, China.
Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China; Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, China.
出版信息
Clin Lung Cancer. 2017 May;18(3):e197-e201. doi: 10.1016/j.cllc.2016.11.014. Epub 2016 Dec 2.
BACKGROUND
Currently, molecular profiles and prognosis of primary pulmonary neuroendocrine carcinoma (PNC) are poorly elucidated. The present study was designed to evaluate genomic abnormalities and survival in patients with primary PNC.
METHODS
Completely resected PNC samples were collected from Zhejiang Cancer Hospital during the period of 2008 to 2015. Nine driver genes, including 6 mutations (EGFR, KRAS, NRAS, PIK3CA, BRAF, and HER2) and 3 fusions (ALK, ROS1, and RET), were evaluated by reverse transcription-polymerase chain reaction (RT-PCR). Survival analysis was conducted by the Kaplan-Meier method.
RESULTS
A total of 108 patients with pathologically confirmed PNC were enrolled. The types were pulmonary large-cell neuroendocrine carcinoma (PLCNC, n = 52), small-cell lung cancer (SCLC, n = 44), and carcinoid (n = 12). Twelve patients (11.1%) harbored genomic aberrations. The most frequent gene abnormalities in decreasing order were PIK3CA (n = 5, 4.6%), EGFR (n = 3, 2.8%), KRAS (n = 2, 1.9%), ALK (n = 1, 0.9%), and RET (n = 1, 0.9%). No ROS1, BRAF, NRAS, or HER2 mutation was detected. The frequencies of gene aberrations were 15.4%, 6.8%, and 8.3% in PLCNC, SCLC, and carcinoid, respectively. Survival differences existed among PLCNC, SCLC, and carcinoid groups (37.0 vs. 34.0 vs. not reached, P = .035); however, no difference existed between PLCNC and SCLC groups (P = .606).
CONCLUSIONS
Genomic abnormality is rare in patients with PNC and it is the most frequently observed in PLCNC.
背景
目前，原发性肺神经内分泌癌（PNC）的分子特征和预后仍未得到充分阐明。本研究旨在评估原发性PNC患者的基因组异常情况及生存情况。
方法
收集2008年至2015年期间在浙江省肿瘤医院完整切除的PNC样本。通过逆转录聚合酶链反应（RT-PCR）评估9个驱动基因，包括6个突变基因（EGFR、KRAS、NRAS、PIK3CA、BRAF和HER2）和3个融合基因（ALK、ROS1和RET）。采用Kaplan-Meier法进行生存分析。
结果
共纳入108例经病理证实的PNC患者。病理类型包括肺大细胞神经内分泌癌（PLCNC，n = 52）、小细胞肺癌（SCLC，n = 44）和类癌（n = 12）。12例患者（11.1%）存在基因组畸变。按出现频率从高到低排列，最常见的基因异常依次为PIK3CA（n = 5，4.6%）、EGFR（n = 3，2.8%）、KRAS（n = 2，1.9%）、ALK（n = 1，0.9%）和RET（n = 1，0.9%）。未检测到ROS1、BRAF、NRAS或HER2突变。PLCNC、SCLC和类癌中基因畸变的频率分别为15.4%、6.8%和8.3%。PLCNC、SCLC和类癌组之间存在生存差异（37.0对34.0对未达到，P = .035）；然而，PLCNC组和SCLC组之间无差异（P = .606）。
结论
PNC患者中基因组异常情况较为罕见，在PLCNC中最为常见。
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