Thoracic Oncology Division, Department of Pulmonology and Respiratory Medicine, Universitas Sumatera Utara, Medan, Sumatera Utara, 20155, Indonesia.
Department of Pulmonology and Respiratory Medicine, Universitas Sumatera Utara, Medan, Sumatera Utara, 20155, Indonesia.
F1000Res. 2023 Jun 15;11:853. doi: 10.12688/f1000research.113303.2. eCollection 2022.
Gaining a better understanding of molecular alterations in the pathogenesis of lung cancer reveals a significant change in approach to the management and prognosis of lung cancer. Several oncogenes and tumor suppressor genes have been identified and have different roles related to survival rates in lung cancer patients. This study aims to determine the role of KRAS, EGFR, and TP53 mutations in the survival rate of lung cancer patients in the population of North Sumatra. This is a retrospective cohort study involving 108 subjects diagnosed with lung cancer from histopathology specimens. DNA extractions were performed using FFPE followed by PCR examinations for assessing the expressions of EGFR, RAS, and TP53 protein. Sequencing analysis was carried out to determine the mutations of EGFR exon 19 and 21, RAS protein exon 2, and TP53 exon 5-6 and 8-9. Data input and analysis were conducted using statistical analysis software for Windows. The survival rate analysis was presented with Kaplan Meier. Results: 52 subjects completed all procedures in this study. Most of the subjects are male (75%), above 60 years old (53.8%), heavy smokers (75%), and suffer from adenocarcinoma type of lung cancer (69.2%). No subjects showed KRAS exon 2 mutations. Overall survival rates increased in patients with EGFR mutations (15 months compared to 8 months; =0.001) and decreased in patients with TP53 mutations (7 months compared to 9 months; =0.148). Also, there was increasing Progression-Free Survival in patients with EGFR mutations (6 months compared to 3 months) ( =0.19) and decreasing PFS in patients with TP53 mutations (3 months compared to 6 months) ( =0.07). There were no KRAS mutations in this study. EGFR mutations showed a higher survival rate, while TP53 mutations showed a lower survival rate in overall survival and progression-free survival.
更好地了解肺癌发病机制中的分子改变，揭示了肺癌管理和预后方法的重大变化。已经确定了几个癌基因和肿瘤抑制基因，它们在肺癌患者的生存率方面具有不同的作用。本研究旨在确定 KRAS、EGFR 和 TP53 突变在北苏门答腊肺癌患者生存率中的作用。 这是一项回顾性队列研究，涉及 108 名经组织病理学标本诊断为肺癌的患者。使用 FFPE 进行 DNA 提取，然后进行 PCR 检查，以评估 EGFR、RAS 和 TP53 蛋白的表达。进行测序分析以确定 EGFR 外显子 19 和 21、RAS 蛋白外显子 2 以及 TP53 外显子 5-6 和 8-9 的突变。使用 Windows 统计分析软件进行数据输入和分析。使用 Kaplan-Meier 呈现生存率分析。结果：52 名患者完成了本研究的所有程序。大多数患者为男性（75%），年龄在 60 岁以上（53.8%），重度吸烟者（75%），患有腺癌型肺癌（69.2%）。没有患者显示 KRAS 外显子 2 突变。EGFR 突变患者的总生存率增加（15 个月比 8 个月；=0.001），TP53 突变患者的总生存率降低（7 个月比 9 个月；=0.148）。此外，EGFR 突变患者的无进展生存期增加（6 个月比 3 个月）（=0.19），TP53 突变患者的无进展生存期降低（3 个月比 6 个月）（=0.07）。本研究中没有 KRAS 突变。EGFR 突变显示生存率较高，而 TP53 突变在总生存率和无进展生存率方面显示生存率较低。
