Cao H, Zheng J, Zhao J, Guo X J, Zhou J Y, Ding W, Zhou J Y
Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Zhejiang University Medical College, Hangzhou 310003, China.
Department of Pathology, First Affiliated Hospital of Zhejiang University Medical College, Hangzhou 310003, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2020 Feb 12;43(2):120-125. doi: 10.3760/cma.j.issn.1001-0939.2020.02.009.
To study the prevalence of c-ros oncogene 1 fusion in lung adenocarcinoma and to evaluate its relationship with clinical characteristics. We retrospectively analyzed epidermal growth factor receptor (EGFR) mutation, anaplastic lymphoma kinase (ALK) and c-ros oncogene 1 (ROS1) fusion in 1 482 patients with adenocarcinoma from March 2014 to January 2017 in the first affiliated hospital of Zhejiang University. Furthermore, ROS1 fusion positive patients diagnosed between February 2017 and December 2017 were also included in ROS1 positive group. The data of age, sex, smoking history, TNM stage and chest computed tomography were collected by Electronic Medical Record (EMR). The clinical data were compared by the chi-squared test or Mann-Whitney test. Of these 1 482 patients,54 cases were diagnosed with ROS1 rearrangement, including 19 males and 35 females, while 73 cases were diagnosed with ALK rearrangement, including 28 males and 45 females, and 679 cases diagnosed with EGFR mutation including 293 males and 386 females. And there were 676 patients without driven genes mutation. The mean age in ROS1 fusion group (54±12) was lower than EGFR mutation group (60±11, -3.982, 0.001) and WT group (62±10, -4.944, 0.001). Female proportion in ROS1 fusion group (64.8%, 35/54) was higher than WT group (28.4%, 192/676, χ(2)=30.94, 0.001). Non-smoker percentages in ROS1 fusion group (72.2%, 39/54) was significantly higher than WT group (38.0%,257/676, χ(2)=24.27, 0.001). ROS1 fusion group was similar to ALK fusion group in sex, age and smoking history, and there were no significant difference in TNM stage among these groups. On chest CT, adenocarcinomas with ROS1 fusion were found to be more peripheral in location (71.4%, 20/28) and solid in density (75%, 21/28), usually with lobulated margins (75.0%, 21/28) and spiculated in contour (57.1%,16/28). In our study lung adenocarcinoma with c-ROS oncogene 1 fusion was a rare subtype lung cancer and was usually detected in young, never smoking, and female patients.
研究肺腺癌中c-ros癌基因1融合的发生率，并评估其与临床特征的关系。我们回顾性分析了2014年3月至2017年1月在浙江大学第一附属医院的1482例腺癌患者的表皮生长因子受体（EGFR）突变、间变性淋巴瘤激酶（ALK）和c-ros癌基因1（ROS1）融合情况。此外，2017年2月至12月诊断为ROS1融合阳性的患者也纳入ROS1阳性组。通过电子病历（EMR）收集年龄、性别、吸烟史、TNM分期和胸部计算机断层扫描数据。临床数据采用卡方检验或曼-惠特尼检验进行比较。在这1482例患者中，54例诊断为ROS1重排，其中男性19例，女性35例；73例诊断为ALK重排，其中男性28例，女性45例；679例诊断为EGFR突变，其中男性293例，女性386例。还有676例患者无驱动基因突变。ROS1融合组的平均年龄（54±12）低于EGFR突变组（60±11，-3.982，0.001）和野生型组（62±10，-4.944，0.001）。ROS1融合组的女性比例（64.8%，35/54）高于野生型组（28.4%，192/676，χ(2)=30.94，0.001）。ROS1融合组的非吸烟者比例（72.2%，39/54）显著高于野生型组（38.0%，257/676，χ(2)=24.27，0.001）。ROS1融合组在性别、年龄和吸烟史方面与ALK融合组相似，这些组在TNM分期上无显著差异。在胸部CT上，发现ROS1融合的腺癌在位置上更偏向周边（71.4%，20/28），密度上更实（75%，21/28），通常边缘呈分叶状（75.0%，21/28），轮廓呈毛刺状（57.1%，16/28）。在我们的研究中，具有c-ROS癌基因1融合的肺腺癌是一种罕见的肺癌亚型，通常在年轻、从不吸烟的女性患者中检测到。
