液体活检检测到 KRAS 突变患者的临床特征。
Clinical characteristics of patients with KRAS mutation detected by liquid biopsy.
机构信息
Department of Thoracic Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, Tokyo, Japan.
出版信息
Thorac Cancer. 2023 Nov;14(33):3317-3322. doi: 10.1111/1759-7714.15123. Epub 2023 Sep 26.
BACKGROUND
KRAS mutation positive lung cancer is known to be clinically characterized by older age, males, and smokers. It is reported to be more common in mucinous adenocarcinoma, but all reports are based on analysis of tissue samples. Recently, blood samples have become available for analysis, suggesting a low detection rate of circulating tumor DNA in histological types, especially mucinous adenocarcinoma. In this study, we investigated the clinical characteristics of KRAS mutation-positive cases in the analysis of blood specimens, as these remain unclear.
METHODS
The clinical background of patients with KRAS mutation among those who underwent next-generation sequencing (NGS) analysis using blood samples was evaluated.
RESULTS
NGS analysis was performed on 214 blood samples. KRAS mutations were detected in blood samples in 33 cases (15.4%), of which 31 cases (14.5%) had a histological pathology diagnosis. Mucinous adenocarcinoma accounted for 28.6% of cases with positive blood and tissue specimens, 10.0% of cases with positive blood specimens only, and 57.1% of cases with positive tissue specimens only. Mucinous adenocarcinoma tended to be less common in cases with positive blood specimens. In KRAS-positive patients with lung metastasis only, only one nonmucinous adenocarcinoma had a positive blood sample, and the others all had mucinous adenocarcinomas with positive tissue samples only.
CONCLUSION
The results showed that the detection rate of KRAS-positive lung cancers detected by blood and tissue samples differs, and that the detection rate of blood samples may be poor, especially in the case of mucinous adenocarcinoma with lung metastases only.
背景
KRAS 突变阳性肺癌的临床特征已知为年龄较大、男性和吸烟者。据报道，它在黏液性腺癌中更为常见，但所有报告都是基于组织样本的分析。最近，血液样本可用于分析，这表明在组织学类型中，循环肿瘤 DNA 的检测率较低，特别是黏液性腺癌。在这项研究中，我们研究了血液样本分析中 KRAS 突变阳性病例的临床特征，因为这些特征尚不清楚。
方法
评估了使用血液样本进行下一代测序（NGS）分析的患者中 KRAS 突变阳性病例的临床背景。
结果
对 214 个血液样本进行了 NGS 分析。在 33 例血液样本中检测到 KRAS 突变（15.4%），其中 31 例（14.5%）有组织病理学诊断。在血液和组织标本均为阳性的病例中，黏液性腺癌占 28.6%，仅血液标本为阳性的病例占 10.0%，仅组织标本为阳性的病例占 57.1%。在仅肺转移且 KRAS 阳性的患者中，仅有 1 例非黏液性腺癌的血液样本为阳性，其余均为仅组织样本为阳性的黏液性腺癌。
结论
结果表明，血液和组织样本检测到的 KRAS 阳性肺癌的检出率不同，血液样本的检出率可能较差，特别是在仅肺转移且仅有黏液性腺癌的情况下。
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