Non-small cell lung cancer with EML4-ALK translocation in Chinese male never-smokers is characterized with early-onset

BMC Cancer

Yongjun Guo³  Jie Ma³  Xiaodong Lyu³  Hai Liu²  Bing Wei³  Jiuzhou Zhao³  Shuang Fu⁴  Lu Ding¹  Jihong Zhang⁴ 

[1] Shanghai Yuanqi Bio-pharmaceutical Company Ltd, No. 699 North Huifeng Road, Shanghai 201403, China

[2] The Institute of Forensic Science and Technology of Henan Provincial Public Security Bureau, No. 9 JinShui Road, ZhengZhou, Henan 450003, China

[3] The Affiliated Tumor Hospital of Zhengzhou University, Henan Cancer Hospital, No. 127, Dongming Road, Zhengzhou, Henan 450008, China

[4] Hematology Laboratory of Hematology Malignancy Treatment Center, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang, Liaoning 100022, China

关键词: Adenocarcinoma;    Never-smokers;    Tyrosine kinase inhibitors (TKIs);    Echinoderm microtubule-associated protein-like 4 (EML4);    Anaplastic lymphoma kinase (ALK);    Non-small-cell lung cancers (NSCLCs);   

Others  :  1118278
DOI  :  10.1186/1471-2407-14-834

 received in 2013-12-06, accepted in 2014-10-30,  发布年份 2014

【 摘 要 】

Background

The translocations of the anaplastic lymphoma kinase (ALK) gene with the echinoderm microtubule-associated protein-like 4 (EML4) gene on chromosome 2p have been identified in non-small-cell lung cancers (NSCLCs) as oncogenic driver mutations. It has been suggested that EML4-ALK fusion is associated with the resistance in NSCLCs to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs), such as gefitinib and erlotinib. In contrast, ALK tyrosine kinase inhibitor (ALK TKI) crizotinib has shown superior effects in combating NSCLCs with EML4-ALK. Thus, characterization of EML4-ALK fusion genes and clinical features of resulting carcinomas would be a great benefit to disease diagnosis and designing customized treatment plans. Studies have suggested that EML4-ALK translocation occurs more frequently in never-smokers with NSCLC, especially in female patients. However, it is not clear whether this is the case in male patients, too. In this study, we have determined the frequency of EML4-ALK translocation in male never-smokers with NSCLC in a cohort of Chinese patients. The clinical features associated with EML4-ALK translocation were also investigated.

Methods

A cohort of 95 Chinese male never-smokers with NSCLC was enrolled in this study. EML4-ALK fusion genes were detected using one-step real time RT-PCR and DNA sequencing. We further determined the expression levels of ALK mRNA by RT-PCR and ALK protein by immunohistochemistry in these specimens. The clinical features of EML4-ALK–positive carcinomas were also determined.

Results

We have identified EML4-ALK fusion genes in 8 out of 95 carcinoma cases, accounting for 8.42% in Chinese male never-smokers with NSCLC. It is significantly higher than that in all Chinese male patients (3.44%) regardless smoking habit. It is also significantly higher than that in all Chinese smokers (8/356 or 2.25%) or in smokers worldwide (2.9%) by comparing to published data. Interestingly, EML4-ALK fusion genes are more frequently found in younger patients and associated with less-differentiated carcinomas.

Conclusions

The frequency of EML4-ALK translocation is strongly associated with smoking habits in Chinese male patients with higher frequency in male never-smokers. EML4-ALK translocation is associated with early-onset and less-differentiated carcinomas.

【 授权许可】

   
2014 Guo et al.; licensee BioMed Central Ltd.

【 图 表 】

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