Clinicoradiopathological features and prognosis according to genomic alterations in patients with resected lung adenocarcinoma

Journal of Thoracic Disease

article

Yeonseok Choi¹  Sang-Won Um¹  Ki-Hwan Kim²  Byeong-Ho Jeong¹  Kyung-Jong Lee¹  Hojoong Kim¹  O. Jung Kwon¹  Jhingook Kim³  Yoon-La Choi⁴  Ho Yun Lee⁵ 

[1] Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine;Department of Radiology, Myongji Hospital;Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine;Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine;Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine;Department of Health Sciences and Technology, Sungkyunkwan University

关键词: Lung adenocarcinoma;    solidity;    epidermal growth factor receptor (EGFR);    anaplastic lymphoma kinase (ALK);    Kirsten rat sarcoma viral oncogene homolog (KRAS);   

DOI  :  10.21037/jtd-20-1716

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: We investigated the clinicoradiopathological features and prognosis according to genomic alterations in patients with surgically resected lung adenocarcinoma. Methods: Patients who underwent surgical resection for pathologic stage I, II, or IIIA lung adenocarcinoma between 2009 and 2016 and for whom results regarding EGFR mutation, ALK immunohistochemistry (IHC), and KRAS mutation were available were included. Clinicoradiopathological characteristics, genomic alterations, and disease-free survival were analyzed retrospectively. Results: Of 164 patients, 86 (52.4%) were female and 94 (57.3%) were never-smokers. The most common imaging patterns were part-solid lesion (67.7%) followed by solid (26.2%) and non-solid (6.1%) lesions. EGFR mutation, ALK IHC, and KRAS mutation were positive in 95 (57.9%), 9 (5.5%), and 11 (6.7%) patients, respectively. EGFR mutation positivity was associated with female sex, never-smoker, subsolid pattern on radiological examination, and acinar or papillary predominant histologic subtype. ALK IHC positivity was associated with longer maximal diameter, advanced stage, solid pattern on radiological examination, solid predominant histologic subtype, and distant metastasis during follow-up. KRAS mutation positivity was associated with male sex, smoker, solid pattern on radiological examination, and invasive mucinous adenocarcinoma on histologic analysis. In multivariable analysis, ALK IHC positivity and lymph node involvement were independently associated with recurrence. However, solidity was not an independent risk factor for recurrence. Conclusions: Genomic alterations are associated with clinicoradiopathologic features in patients with resected lung adenocarcinoma. Identifying genomic alterations could help to predict the prognosis of early-stage lung adenocarcinoma.

【 授权许可】

Unknown