Motta Lucia, Molinari Francesca, Pankovics Jana, Pedrazzini Benjamin, Valera Alexandra, Epistolio Samantha, Giudici Luca, Freguia Stefania, Patella Miriam, Imbimbo Martina, Schiavone Giovanna, Frattini Milo, Froesch Patrizia
Oncological Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland.
Institute of Pathology, Ente Ospedaliero Cantonale (EOC), 6900 Locarno, Switzerland.
J Clin Med. 2025 Jul 19;14(14):5135. doi: 10.3390/jcm14145135.
: The clinical value of mutations in lung adenocarcinoma, alone or in combination with other mutations, has been assessed especially in advanced stages. This study evaluates how and the presence of co-mutations could affect survival in early-stage lung. : We analyzed a real-world cohort including all staged NSCLC patients diagnosed and treated from 2018 to 2022 at our Institute with availability of NGS molecular data. Statistical analyses were made using log-rank test, the two-tailed Fisher's exact test and Kaplan-Meier survival curves. : mutations were observed in 179/464 cases (38.6%). The majority of co-mutations were in (74%) and (14.3%) genes. + co-mutations were more frequent compared to -only tumors in stage IV NSCLC ( = 0.01). In early stage and locally advanced cases (stage I-III), better prognosis was associated to -only mutated NSCLC and to + mutated cases compared to + ( = 0.008). In particular, patients carrying + in stage I and II displayed a shorter survival, similar to patients diagnosed at stage III. : Routine NGS provides important information for potential actionable mutations but also for the prognostic and predictive role of the presence of co-occurring mutations. In particular, the presence of + in stage I and II NSCLC may be considered an unfavorable prognostic marker possibly leading to adapt the perioperative chemo-immunotherapy.
肺腺癌中单独或与其他突变联合存在的突变的临床价值，尤其在晚期阶段已得到评估。本研究评估了 [具体突变名称] 突变以及共突变的存在如何影响早期肺癌患者的生存情况。
我们分析了一个真实世界队列，包括2018年至2022年在我院诊断和治疗的所有分期非小细胞肺癌（NSCLC）患者，且这些患者可获取NGS分子数据。使用对数秩检验、双侧Fisher精确检验和Kaplan-Meier生存曲线进行统计分析。
在179/464例病例（38.6%）中观察到 [具体突变名称] 突变。大多数 [具体突变名称] 共突变存在于 [具体基因1]（74%）和 [具体基因2]（14.3%）基因中。与仅 [具体突变名称] 突变的肿瘤相比，IV期NSCLC中 [具体突变名称] + [其他突变名称] 共突变更为频繁（P = 0.01）。在早期和局部晚期病例（I - III期）中，与 [具体突变名称] + [其他突变名称] 突变病例相比，仅 [具体突变名称] 突变的NSCLC和 [具体突变名称] 突变病例预后更好（P = 0.008）。特别是，I期和II期携带 [具体突变名称] 突变的患者生存时间较短，与III期诊断的患者相似。
常规NGS不仅为潜在的可操作突变提供重要信息，也为共发生突变的预后和预测作用提供信息。特别是，I期和II期NSCLC中 [具体突变名称] 突变的存在可能被视为不良预后标志物，可能导致围手术期化疗免疫治疗方案的调整。
