J Korean Med Sci.  2007 Jun;22(3):393-399. 10.3346/jkms.2007.22.3.393.

Clinical Features Reflect Exon Sites of EGFR Mutations in Patients with Resected Non-Small-Cell Lung Cancer

• Na II
• Rho JK
• Choi YJ
• Kim CH
• Koh JS
• Ryoo BY
• Yang SH
• Lee JC

• KMID: 1778343
• DOI: http://doi.org/10.3346/jkms.2007.22.3.393

Abstract

The aim of the current study was to determine the clinical significance according to the subtypes of epidermal growth factor receptor (EGFR) mutations and presence of KRAS mutations in operable non-small-cell lung cancer (NSCLC). We sequenced exons 18-21 of the EGFR tyrosine kinase domain and examined mutations in codons 12 and 13 of KRAS in tissues of patients with NSCLC who had undergone surgical resection. EGFR mutations were more frequent in never-smokers than smokers (33% vs. 14%, respectively; p=0.009) and in females than in males (31% vs. 16%, respectively; p=0.036). Mutations in exon 18-19 and 20-21 were found in 10 and 22 patients, respectively. Never-smokers and broncho-alveolar cell carcinoma features were positively associated with a mutation in exon 18-19 (p=0.027 and 0.016, respectively). The five-year survival rate in patients with a mutation in exons 18-19 (100%) was higher than that in patients without such mutation (47%; p=0.021). KRAS mutations were found in 16 patients (12%) and were not related to the overall survival (p=0.742). Patients with an EGFR mutation in exons 18-19 had better survival than patients without such mutation. Subtypes of EGFR mutations may be prognostic factors in patients undergoing curative resection.

Keyword

Carcinoma, Non-small-cell Lung; Receptor, Epidermal Growth Factor; Genes, Ras; Mutation

MeSH Terms

Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung/diagnosis/*genetics/*surgery
Disease-Free Survival
*Exons
Female
Humans
Lung Neoplasms/diagnosis/*genetics/*surgery
Male
Middle Aged
*Mutation
Proto-Oncogene Proteins p21(ras)/genetics
Receptor, Epidermal Growth Factor/*genetics
Sex Factors
Treatment Outcome

Figure

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  Fig. 1 Kaplan-Meier plots of overall survival according to EGFR mutations.

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  Fig. 2 Kaplan-Meier plots of (A) disease-free survival and (B) overall survival according to the presence of EGFR mutations in exons 18-19.

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  Fig. 3 Overall survival according to KRAS mutations by Kaplan-Meier method.

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  Fig. 4 (A) The final tree fitted by recursive partitioning using an exponential scaling method. The standardized event rate and events/total number of observations per subgroup are given. (B) Kaplan-Meier plots of overall survival according to three different nodes.

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