Long Jinyu, Chen Ying, Luo Xingguang, Rao Ruiying, Wang Chenxi, Guo Yuxin, Xu Jinhe, Lin Ping, Song Yingfang, Qu Lijuan, Liu Qinghong, Lu Jun, Zhou Chengzhi, Song Zhengbo, Lin Xiandong, Adachi Hiroyuki, Jassem Jacek, Hamaji Masatsugu, Yu Zongyang
Department of Respiratory and Critical Care Medicine, Fuzong Teaching Hospital, Fujian University of Traditional Chinese Medicine (900th Hospital), Fuzhou, China.
Department of Respiratory and Critical Care Medicine, The 900th Hospital of the Joint Logistic Support Force, People's Liberation Army of China, Fuzhou, China.
Transl Lung Cancer Res. 2024 Aug 31;13(8):1938-1949. doi: 10.21037/tlcr-24-381. Epub 2024 Aug 19.
Patients with non-small cell lung cancer (NSCLC) carrying mutations (-Mut) tend to have more advanced disease and a poor prognosis. However, due to the rarity of this mutation and the lack of related studies, the characteristics of -Mut NSCLC patients remains poorly determined. To clarify the clinical characteristics and prognostic factors of -Mut NSCLC, we initiated the present study to provide a clinical reference.
We used data from two cohorts of NSCLC--mutated samples: The Cancer Genome Atlas (TCGA) database and our center's clinical data. The TCGA database was used to obtain 481 NSCLC--Mut samples for clinical characterization. The center collected data on 224 consecutive NSCLC patients treated between December 2020 to July 2022. Among them, 26 harbored mutations, and 20 were eligible for inclusion in the study. Clinical, pathological, and molecular features, as well as prognostic role of mutations were analyzed. Additionally, we analyzed the prognostic impact of Napsin A expression in -Mut patients.
The TCGA database included 480 patients with -Mut NSCLC, 311 males (64.8%) and 169 females (35.2%), with a median age of 67 years. Among the 20 -Mut patients in our center series, 12 (60%) were males and 8 (40%) females, with a median age of 63. The intergroup prognostic correlation analysis showed that -Mut patients had significantly worse prognosis than those the wild-type (-WT) (P=0.04). Within the -Mut group, patients with Napsin A expression had longer overall survival (OS) (P=0.03) than those without expression. Median survival in the Napsin A-positive and negative groups was 32 and 15 months, respectively. According to time-dependent receiver operating curve analysis, patients with Napsin A expression had significantly longer first-line treatment progression-free survival (PFS1) [area under the curve (AUC) =0.748] and OS (AUC =0.586). No prognostic value of Napsin A was found in patients -WT patients.
-Mut is an adverse prognostic feature in NSCLC patients. Napsin A expression in -Mut patients is associated with prolonged OS.
携带 突变（-Mut）的非小细胞肺癌（NSCLC）患者往往疾病进展更严重且预后较差。然而，由于这种突变罕见且缺乏相关研究，-Mut NSCLC患者的特征仍未明确。为阐明 -Mut NSCLC的临床特征和预后因素，我们开展了本研究以提供临床参考。
我们使用了两个NSCLC -突变样本队列的数据：癌症基因组图谱（TCGA）数据库和我们中心的临床数据。TCGA数据库用于获取481个NSCLC - Mut样本进行临床特征分析。该中心收集了2020年12月至2022年7月期间连续治疗的224例NSCLC患者的数据。其中，26例携带 突变，20例符合纳入本研究的条件。分析了临床、病理和分子特征以及 突变的预后作用。此外，我们分析了Napsin A表达对 -Mut患者的预后影响。
TCGA数据库包括480例 -Mut NSCLC患者（男性311例，占64.8%；女性169例，占35.2%），中位年龄67岁。在我们中心队列的20例 -Mut患者中，男性12例（60%），女性8例（40%），中位年龄63岁。组间预后相关性分析显示，-Mut患者的预后明显比野生型 （-WT）患者差（P = 0.04）。在 -Mut组中，Napsin A表达阳性的患者总生存期（OS）更长（P = 0.03）。Napsin A阳性和阴性组的中位生存期分别为32个月和15个月。根据时间依赖性受试者工作特征曲线分析，Napsin A表达阳性的患者一线治疗无进展生存期（PFS1）[曲线下面积（AUC） = 0.748]和OS（AUC = 0.586）明显更长。在 -WT患者中未发现Napsin A的预后价值。
-Mut是NSCLC患者的不良预后特征。-Mut患者中Napsin A表达与OS延长相关。
