Sun Fei, Wang Pengcheng, Zheng Yiming, Jia Weiguang, Liu Fuxing, Xiao Wei, Bao Jingjing, Wang Song, Lu Kaijin
Department of Cardiothoracic Surgery, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China.
Department of Pathology, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China.
Oncol Lett. 2018 Jan;15(1):489-494. doi: 10.3892/ol.2017.7312. Epub 2017 Oct 31.
Primary pulmonary mucinous adenocarcinoma (PPMA) is an uncommon subtype of lung adenocarcinoma. The present study attempted to clarify the diagnosis, clinicopathological characteristics, and pathologic significance of epithelial growth factor receptor (EGFR) and Kirsten rat sarcoma viral oncogene (KRAS) mutations and the prognosis of PPMA. A total of 29 patients with PPMA from among 1,469 surgically resected patients with lung adenocarcinoma were enrolled. All of the tumours expressed CK7 and 5 cases exhibited co-expression with CK20. A total of 8 cases expressed EGFR, 14 cases expressed P53 and 2 cases expressed CEA. The majority of mucinous adenocarcinomas expressed thyroid transcription factor 1, Napsin A, Villin and Cam5.2 proteins. KRAS mutations were observed in 62% of patients and were more prevalent in the lower lung lobe and in patients with invasive mucinous adenocarcinoma. A total of 2 cases exhibited an EGFR mutation, and the co-mutation of KRAS and EGFR was only detected in 1 case. The relapse-free and overall survival rates at 5 years were 70.4, and 81.5%, respectively. The results may assist to identify a molecular target and supply important information for a therapeutic strategy for patients with PPMA.
原发性肺黏液腺癌（PPMA）是肺腺癌中一种罕见的亚型。本研究旨在阐明上皮生长因子受体（EGFR）和 Kirsten 大鼠肉瘤病毒癌基因（KRAS）突变在PPMA中的诊断、临床病理特征、病理意义及预后情况。在1469例接受手术切除的肺腺癌患者中，共纳入了29例PPMA患者。所有肿瘤均表达CK7，5例同时表达CK20。共有8例表达EGFR，14例表达P53，2例表达CEA。大多数黏液腺癌表达甲状腺转录因子1、Napsin A、绒毛蛋白和Cam5.2蛋白。62%的患者存在KRAS突变，在下肺叶及浸润性黏液腺癌患者中更为常见。共有2例出现EGFR突变，仅1例检测到KRAS和EGFR的共突变。5年无复发生存率和总生存率分别为70.4%和81.5%。这些结果可能有助于确定分子靶点，并为PPMA患者的治疗策略提供重要信息。
