Associations between epidermal growth factor receptor mutations and histological subtypes of lung adenocarcinoma according to the IASLC/ATS/ERS classification in Chinese patients

Abstract

BackgroundThis retrospective study was conducted to investigate the relationship between epidermal growth factor receptor (EGFR) mutation and histological subtypes of lung adenocarcinoma according to the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) classification in Chinese patients.MethodsThree hundred and seventy six surgically resected lung adenocarcinomas from Chinese PLA General Hospital were included in the study. Patients’ clinical and pathological characteristics including age, gender, smoking history, tumor size, tumor node metastasis stage, and tumor differentiation were analyzed. Histologic subtypes of adenocarcinoma were categorized according to the IASLC/ATS/ERS classification of lung adenocarcinoma. An amplification‐refractory mutation system was performed to detect EGFR mutations.ResultsOne hundred and fifty three lung adenocarcinomas had EGFR mutations. In univariate analysis, EGFR mutations were associated with gender (P < 0.001), smoking history (P < 0.001), tumor differentiation (P < 0.001), and acinar predominant (P < 0.001), papillary predominant (P = 0.034), solid predominant (P = 0.022), invasive mucinous (P = 0.012) and mucinous (P = 0.001) subtypes.ConclusionsIn Chinese patients with lung adenocarcinoma, smoking history, tumor differentiation, and acinar predominant and mucinous subtypes were independent predictors of EGFR mutation.

Association of histologic subtypes with genetic alteration and PD‑L1 expression in pulmonary adenocarcinoma

“…The histological subtype with the highest level of significance in terms of its association with the EGFR mutation, based on the present study, was the papillary subtype (P= 0.038; OR 2.793). This finding concurred with those of previous studies: A significant association between EGFR and micropapillary, lepidic, acinar or papillary subtypes were identified in studies by Wang et al (29) (34), that included 864 patients with ADC revealed that mucinous ADC, as well as extracellular mucin production, were also significantly associated with the KRAS mutation.…”

“…The histological subtype with the highest level of significance in terms of its association with the EGFR mutation, based on the present study, was the papillary subtype (P=0.038; OR 2.793). This finding concurred with those of previous studies: A significant association between EGFR and micropapillary, lepidic, acinar or papillary subtypes were identified in studies by Wang et al ( 29 ) who analyzed 153 cases, Li et al ( 30 ) who investigated 230 cases, Yoshizawa et al ( 31 ) who analyzed 440 cases, and Dong et al ( 32 ) who analyzed 330 cases. In investigating KRAS- mutated NSCLC, several studies have demonstrated that the KRAS mutation is associated with mucinous ADC, including studies by Dong et al ( 32 ) (330 cases) and Marchetti et al ( 33 ) (58 cases).…”

<p>Prognostic analysis of patients with mutant and wild-type <em>EGFR</em> gene lung adenocarcinoma</p>

“…In our study, the prevalence of EGFR gene mutation was higher in female, nonsmoker, and well and moderated differentiation, which was similar to previous reports from the East Asian countries 9,10,18. Furthermore, we also found that the rate of EGFR gene mutation was not associated with specimen types, and there were no significant differences in maximum diameter of tumor, lymph node metastasis, and pleural metastasis of surgical specimen.…”

18F‐fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of clinically node‐negative non‐small cell lung cancer

“…It should be noted that the aforementioned reports described East Asian populations, which have been known to have a relatively greater proportion of ADC compared with other NSCLC. 41,42 Furthermore, most of the studies included non-stage IA patients, and used a variety of cutoff values for SUVmax. The SUVmax prediction accuracy may be improved if combined with additional criteria, such as tumor size and tumor location, as proposed by the American College of Chest Physicians guidelines.…”

“…It should be noted that the aforementioned reports described East Asian populations, which have been known to have a relatively greater proportion of ADC compared with other NSCLC . Furthermore, most of the studies included non‐stage IA patients, and used a variety of cut‐off values for SUVmax.…”