The Correlation between EGFR Mutation Status and DNA Content of Lung Adenocarcinoma Cells in Pleural Effusion

Abstract

Objectives: Lung adenocarcinomas with or without epidermal growth factor receptor (EGFR) mutations have shown different drug effects against EGFR inhibitors. But it is not very clear if EGFR mutation status affects the biological behavior of lung adenocarcinoma, because tumor gene regulation is very complicated and can be affected by many factors. We aimed to explore if EGFR mutation status is related with tumor malignant degree by investigating the relevance of EGFR mutation status with DNA content and aneuploid peaks of lung adenocarcinoma cells in pleural fluids without using EGFR-TKIs. Materials and Methods: 591 cases of lung adenocarcinoma patients in Hebei Tumor Hospital who had undergone EGFR gene detection and DNA quantitative analysis were collected from January 2012 to August 2018.They were divided into two groups: EGFR mutant group and non-mutant group. EGFR mutations were detected by Amplification Refractory Mutation System (ARMS) and ABI 7500 Fluorescence quantitative PCR with pleural effusions. DNA content and aneuploid peaks were detected by LD DNA image cytometry (DNA-ICM). Rank-sum test of SPSS 16 was used for statistical analysis. Results: The maximum DI, the mean DI of the first 20 cells greater than 5C, the percentage of cells greater than 5C and the number of cells greater than 9C of the first 20 cells in the mutant group were all higher than those in the non-mutant group, having statistical significance (p<0.001); the peaks of aneuploid cells in the mutant group occurred more often than those in the non-mutant group, having statistical significance (p<0.001). Conclusions: Our study has shown that advanced lung adenocarcinomas with EGFR-mutations had higher DI values, more aneuploid cells and more frequent aneuploid peaks compared with those without EGFR-mutations, suggesting that advanced lung adenocarcinomas with EGFR mutations are more aggressive than those without EGFR mutations.

A narrative review on the implementation of liquid biopsy as a diagnostic tool in thoracic tumors during the COVID-19 pandemic

“…For example, one study by Du et al showed that quantitative PCR was able to detect EGFR mutations in 591 pleural effusions from NSCLC patients. Another study showed similar results in saliva ( 27 ). In particular, the authors successfully isolated genetic material from the saliva of patients diagnosed with NSCLC, pancreatic cancer, breast cancer, gastric cancer, and head and neck squamous cell carcinoma ( 28 ).…”

Survival of Lung Adenocarcinoma Patients with Tyrosine Kinase Inhibitor Therapy Based on EGFR Mutation Status in Tumor and Plasma Samples

“…A total of 7 patients were male, 9 were over 50 years old, 8 had a history of smoking, and the majority of 13 were at the IVA stage. Patients with concordance positive results of tumor sample and ctDNA was confirmed by examination of pathology of pleural fluid (8), pulmonary masses (2), supraclavicular lymph node (3), and neck lymph node (1) with the result of 9 patients constituting exon 19 mutations.…”

“…Meanwhile, differences were obtained in OS where lung adenocarcinoma patients who have also detected mutations had a shorter OS of 7.5 vs. 25.5 months (Figure 2). growth and progression [8]. EGFR-specific mutations have been connected to increased survival in NSCLC patients [9].…”