한빛사 논문
Sarah Park MD*,†, Alison J. Holmes-Tisch MD, PhD†, Eun Yoon cho MD, PhD‡, Young Mog Shim MD, PhD§, Jinkook Kim MD, PhD§, Hyo Song Kim MD∥, Jeeyun Lee MD, PhD∥, Yeon Hee Park MD, PhD∥, Jin Seok Ahn MD, PhD∥, Keunchil Park MD, PhD∥, Pasi A. Jänne MD, PhD†, Myung-Ju Ahn MD, PhD∥
*Division of Hematology-Oncology, Department of Medicine, Hangang Sacred Heart Hospital, Hallym University School of Medicine, Seoul, Korea
†Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
‡Departments of Pathology, Seoul, Korea
§Departments of Thoracic and Cardiovascular Surgery, Seoul, Korea
∥Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Corresponding author: Pasi A. Jänne MD, PhD, Myung-Ju Ahn MD, PhD
Abstract
Introduction:
For the identification of the patients who most likely benefit from epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC), molecular assays are considered to be of paramount importance. Given the heterogeneity of NSCLC at the molecular level, this study was conducted to determine the discrepancy in EGFR mutations between primary tumors and the corresponding lymph node metastasis.
Patients and Methods:
Surgically resected 101 paired primary NSCLC and metastatic lymph nodes were evaluated for the EGFR mutations by direct DNA sequencing and heteroduplex analysis.
Results:
EGFR mutation was detected in 29.7% (30 of 101) of the primary tumors and in 27.7% of lymph node metastases (28 of 101) by either direct sequencing or heteroduplex analysis, respectively. By direct sequencing, 12 cases (11.9%) showed discordance in EGFR mutations between primary tumors and metastasis. In 11 cases, EGFR mutations were detected only in the primary tumor, whereas 1 case only in lymph node metastases. By heteroduplex analysis, 17 cases (16.8%) were discordant. Ten cases were primary tumor positive and lymph node negative, whereas seven cases were lymph node positive and primary tumor negative.
Conclusions:
A considerable proportion of NSCLC showed discrepancy in EGFR mutations between primary tumors and metastatic lymph nodes, suggesting tumor heterogeneity at the molecular level during the process of metastasis.
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