Wang Fang, Lu Jia-Bin, Wu Xiao-Yan, Feng Yan-Fen, Shao Qiong, An Xin, Wang Hai-Yun
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China.
Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Guangzhou 510060, People's Republic of China.
Cancer Manag Res. 2019 Jun 14;11:5489-5499. doi: 10.2147/CMAR.S200263. eCollection 2019.
Large-cell lung carcinomas (LCLCs) were reclassified by the World Health Organization 2015 criteria. and remain fairly unknown at the molecular level and targeted-therapeutic options. Data of 184 lung cancer patients were retrieved from clinical records, of which 54 were found to be pathologically diagnosed as LCLC. The genetic alterations // mutations, MET copy number, and exon 14 mutation, ALK and ROS1 rearrangements, and PDL1 expression were investigated using clinical technologies. The relationship between clinicopathologic and genetic features was analyzed, and the Kaplan-Meier method with log-rank test was used for analyzing patient survival. Major events, including , , and mutations and MET copy-number gain, were found in 5.6%, 16.7%, 1.9%, and 18.5% in LCLC, respectively. No ALK or ROS1 translocation was detected. PDL1 expression in tumor cells and in tumor-infiltrating lymphocytes was observed in 24 (44.4%) and 16 (29.6%) patients. Kaplan-Meier analysis showed that patients with a mutation had ower 5-year overall survival than those with wild-type (25.4% vs 47.8%, =0.028) and that patients with negative PDL1 stained in tumor cells but positive for tumor-infiltrating lymphocytes had significantly favorable overall survival compared to those with solitary and positive PDL1 stained in tumor cells (62.5% vs 20.6%, =0.044). mutations and PDL1 expression can predict patient survival and be potential target options in LCLC.
大细胞肺癌(LCLCs)根据世界卫生组织2015年标准进行了重新分类。在分子水平和靶向治疗选择方面,它们仍然鲜为人知。从临床记录中检索了184例肺癌患者的数据,其中54例经病理诊断为LCLC。使用临床技术研究了基因改变(突变、MET拷贝数、外显子14突变、ALK和ROS1重排以及PDL1表达)。分析了临床病理特征与基因特征之间的关系,并使用带有对数秩检验的Kaplan-Meier方法分析患者生存率。在LCLC中,主要事件(包括 、 、 突变和MET拷贝数增加)分别在5.6%、16.7%、1.9%和18.5%的患者中被发现。未检测到ALK或ROS1易位。在24例(44.4%)和16例(29.6%)患者中观察到肿瘤细胞和肿瘤浸润淋巴细胞中的PDL1表达。Kaplan-Meier分析表明,携带 突变的患者5年总生存率低于野生型患者(25.4%对47.8%,P = 0.028),并且肿瘤细胞中PDL1染色阴性但肿瘤浸润淋巴细胞中PDL1染色阳性的患者与肿瘤细胞中PDL1单独染色阳性的患者相比,总生存率显著更高(62.5%对20.6%,P = 0.044)。 突变和PDL1表达可以预测LCLC患者的生存率,并且是潜在的靶向选择。