Assessment of Epidermal Growth Factor Receptor and K-Ras Mutation Status in Cytological Stained Smears of Non-Small Cell Lung Cancer Patients: Correlation with Clinical Outcomes

Epidermal growth factor receptor (EGFR) and K-ras mutations guide treatment selection in non-small cell lung cancer (NSCLC) patients. Although mutation status is routinely assessed in biopsies, cytological specimens are frequently the only samples available. We determined EGFR and K-ras mutations in...

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Authors: Lozano-Escario, M.D. (María Dolores)|||/items/af4b6129-2049-4083-8d70-40d37f172598, Zulueta, J. (Javier)|||/items/1979cb86-b86c-41b7-8494-1f00acb7eb1f, Echeveste, J.I. (José I.)|||/items/37d13f4f-9c5d-4b46-84f1-6f449c18fb88, Gurpide-Ayarra, L.A. (Luis Alfonso)|||/items/0935e09d-b036-414b-ac0f-688dbfa94d7f, Seijo, L. (Luis)|||/items/abfac499-8cb5-4c80-9152-88309b94a9ae, Martin-Algarra, S. (Salvador)|||/items/2fba8e8b-e087-4ab0-82e3-a4d157f1e0cc, Barrio, A. (Anabel) del|||/items/7af74457-9f16-4239-9930-0876234b45c2, Pio, R. (Rubén)|||/items/d5c409b3-dbed-4f0c-8bad-94c31e0e5a95, Idoate, M.A. (Miguel Ángel)|||/items/7b905180-f34f-450d-934f-8bf7652f84d3, Labiano, T. (Tania)|||/items/d8a4e9ea-c62c-46a6-913e-44626df781b8, Perez-Gracia, J.L. (Jose Luis)|||/items/7be82c5d-4858-4e04-bd77-7ef5a883021b
Format: article
Publication Date:2011
Country:España
Institution:Universidad de Navarra
Repository:Dadun. Depósito Académico Digital de la Universidad de Navarra
Language:English
OAI Identifier:oai:dadun.unav.edu:10171/23549
Online Access:https://hdl.handle.net/10171/23549
Access Level:Open access
Keyword:Adenocarcinoma/drug therapy/genetics
Antineoplastic Agents/therapeutic use
Carcinoma, Non-Small-Cell Lung/drug therapy/genetics
Anatomía patológica
Description
Summary:Epidermal growth factor receptor (EGFR) and K-ras mutations guide treatment selection in non-small cell lung cancer (NSCLC) patients. Although mutation status is routinely assessed in biopsies, cytological specimens are frequently the only samples available. We determined EGFR and K-ras mutations in cytological samples. METHODS: DNA was extracted from 150 consecutive samples, including 120 Papanicolau smears (80%), 10 cell blocks (7%), nine fresh samples (6%), six ThinPrep(R) tests (4%), and five body cavity fluids (3.3%). Papanicolau smears were analyzed when they had >50% malignant cells. Polymerase chain reaction and direct sequencing of exons 18-21 of EGFR and exon 2 of K-ras were performed. EGFR mutations were simultaneously determined in biopsies and cytological samples from 20 patients. Activity of EGFR tyrosine kinase inhibitors (TKIs) was assessed. RESULTS: The cytological diagnosis was adenocarcinoma in 110 samples (73%) and nonadenocarcinoma in 40 (27%) samples. EGFR mutations were identified in 26 samples (17%) and K-ras mutations were identified in 18 (12%) samples. EGFR and K-ras mutations were mutually exclusive. In EGFR-mutated cases, DNA was obtained from stained smears in 24 cases (92%), pleural fluid in one case (4%), and cell block in one case (4%). The response rate to EGFR TKIs in patients harboring mutations was 75%. The mutation status was identical in patients who had both biopsies and cytological samples analyzed. CONCLUSION: Assessment of EGFR and K-ras mutations in cytological samples is feasible and comparable with biopsy results, making individualized treatment selection possible for NSCLC patients from whom tumor biopsies are not available.

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