Original Article
Frequencies of actionable mutations and survival in variants of invasive adenocarcinoma of lung
Abstract
Background: The objective of the present study was to explore the common actionable mutations and survival in variants of invasive adenocarcinoma (VIA) of lung.
Methods: A total of 1,120 lung adenocarcinoma patients with pathologically confirmed VIA and completely resected stage I–IIIA were enrolled from 2010 to 2013. For comparison, we evaluated the gene status and survival of 380 non-VIA lung adenocarcinoma patients. Reverse transcription-polymerase chain reaction (RT-PCR) was utilized for detecting the mutations of EGFR, KRAS, NRAS, PIK3CA, BRAF, HER2 and fusions of ALK, ROS1 and RET. Survival curves were plotted with Kaplan-Meier method.
Results: Thirty-one patients were selected, including invasive mucinous adenocarcinoma (n=15), enteric adenocarcinoma (n=9), colloid adenocarcinoma (n=4) and fetal adenocarcinoma (n=3). The overall frequency of gene abnormality was 48.4% (15/31) in VIA. The gene abnormalities were as follows: KRAS mutation (n=5), ALK rearrangement (n=4), PIK3CA mutation (n=2), EGFR mutation (n=2), HER2 mutation (n=1) and ROS1 rearrangement (n=1). No mutations of NRAS, BRAF or RET were observed. The frequency of gene abnormality was lower in VIA than non-VIA patients (48.4% vs. 74.7%, P=0.0015). No difference in recurrence-free survival (RFS) was found between VIA and non-VIA patients (38.0 vs. 47.0 months, P=0.524). There was a trend of worse overall survival (OS) in VIA than non-VIA patients (48.0 vs. 57.0 months, P=0.052).
Conclusions: As a rare type of lung adenocarcinoma, VIA has a lower frequency of common gene abnormality. Invasive mucinous adenocarcinoma is the most frequent subtype and KRAS represents a predominant actionable mutation in VIA patients. There is a trend of worse survival in VIA than non-VIA patients.
Methods: A total of 1,120 lung adenocarcinoma patients with pathologically confirmed VIA and completely resected stage I–IIIA were enrolled from 2010 to 2013. For comparison, we evaluated the gene status and survival of 380 non-VIA lung adenocarcinoma patients. Reverse transcription-polymerase chain reaction (RT-PCR) was utilized for detecting the mutations of EGFR, KRAS, NRAS, PIK3CA, BRAF, HER2 and fusions of ALK, ROS1 and RET. Survival curves were plotted with Kaplan-Meier method.
Results: Thirty-one patients were selected, including invasive mucinous adenocarcinoma (n=15), enteric adenocarcinoma (n=9), colloid adenocarcinoma (n=4) and fetal adenocarcinoma (n=3). The overall frequency of gene abnormality was 48.4% (15/31) in VIA. The gene abnormalities were as follows: KRAS mutation (n=5), ALK rearrangement (n=4), PIK3CA mutation (n=2), EGFR mutation (n=2), HER2 mutation (n=1) and ROS1 rearrangement (n=1). No mutations of NRAS, BRAF or RET were observed. The frequency of gene abnormality was lower in VIA than non-VIA patients (48.4% vs. 74.7%, P=0.0015). No difference in recurrence-free survival (RFS) was found between VIA and non-VIA patients (38.0 vs. 47.0 months, P=0.524). There was a trend of worse overall survival (OS) in VIA than non-VIA patients (48.0 vs. 57.0 months, P=0.052).
Conclusions: As a rare type of lung adenocarcinoma, VIA has a lower frequency of common gene abnormality. Invasive mucinous adenocarcinoma is the most frequent subtype and KRAS represents a predominant actionable mutation in VIA patients. There is a trend of worse survival in VIA than non-VIA patients.
