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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
Authors: Lozano, M.D. (María Dolores)
Zulueta, J.J. (Javier J.)
Echeveste, J.I. (José I.)
Gurpide, A. (Alfonso)
Seijo, L. (Luis)
Martin-Algarra, S. (Salvador)
Barrio, A. (Anabel) del
Pio, R. (Rubén)
Idoate, M.A. (Miguel Ángel)
Labiano, T. (Tania)
Perez-Gracia, J.L. (José Luis)
Keywords: Adenocarcinoma/drug therapy/genetics
Antineoplastic Agents/therapeutic use
Carcinoma, Non-Small-Cell Lung/drug therapy/genetics
Issue Date: 2011
Publisher: AlphaMed Press
Publisher version:
ISSN: 1083-7159
Citation: Lozano MD, Zulueta JJ, Echeveste JI, Gurpide A, Seijo LM, Martin-Algarra S, et al. 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. Oncologist 2011;16(6):877-885.
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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DA - CUN - Oncología médica - Artículos de revista
DA - CUN - Anatomía patológica - Artículos de revista
DA - CUN - Neumología - Artículos de revista

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