| Multigene mutation analysis of metastatic lymph nodes in non-small cell lung cancer diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration. | |
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MedLine Citation:
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PMID: 21527506 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The importance of biomarker analysis in patients with non-small cell lung cancer (NSCLC) is well known. The purpose of this study was to analyze the mutation status of multiple genes in metastatic lymph nodes obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and to examine the correlation between treatments and outcomes. METHODS: Genetic alterations were analyzed in metastatic hilar or mediastinal lymph nodes diagnosed by EBUS-TBNA in 156 patients with NSCLC. Epidermal growth factor receptor (EGFR) was analyzed using the peptide nucleic acid-locked nucleic acid polymerase chain reaction clamp method (n = 156). V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (K-ras) (exons 2-3) and tumor protein 53 (p53) (exons 4-8) were analyzed by direct sequencing (n = 113). In addition, retrospective chart review was performed for clinical data analysis. RESULTS: EGFR gene mutations were detected in 42 cases (26.9%). Twenty-three patients with EGFR mutations received gefitinib, with an overall response rate (partial response [PR]) of 54.5% and disease control rate (PR + stable disease) of 86.4% (Response Evaluation Criteria in Solid Tumors). K-ras gene mutations were detected in four cases (3.5%), and p53 gene mutations were detected in 47 cases (41.6%). Fifty-two patients underwent conventional chemotherapy (46 patients underwent platinum-based chemotherapy). Patients with p53 gene mutations showed chemoresistance (progressive disease of 42.9%, P = .0339) and a relatively poor prognosis after chemotherapy (P = .1391). CONCLUSIONS: Multigene mutation analysis can be performed in EBUS-TBNA samples of metastatic lymph nodes from patients with NSCLC. EBUS-TBNA allows genetic evaluation of tumor cells within the metastatic node, which may allow physicians to better select treatments, particularly EGFR tyrosine kinase inhibitors. |
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Authors:
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Takahiro Nakajima; Kazuhiro Yasufuku; Akira Nakagawara; Hideki Kimura; Ichiro Yoshino |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2011-04-28 |
Journal Detail:
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Title: Chest Volume: 140 ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-02 Completed Date: 2011-12-29 Revised Date: 2012-01-17 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
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Languages: eng Pagination: 1319-24 Citation Subset: AIM; IM |
Affiliation:
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Division of Thoracic Surgery, Chiba Cancer Center, Chiba, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Analysis of Variance Antineoplastic Agents / therapeutic use Biopsy, Fine-Needle Carboplatin / therapeutic use Carcinoma, Non-Small-Cell Lung / drug therapy, genetics*, pathology* Chi-Square Distribution Cisplatin / therapeutic use DNA Mutational Analysis Drug Resistance, Neoplasm Female Genes, p53 / genetics* Genes, ras / genetics* Humans Lung Neoplasms / drug therapy, genetics*, pathology* Lymphatic Metastasis / genetics*, pathology* Male Middle Aged Neoplasm Staging Polymerase Chain Reaction Prognosis Quinazolines / therapeutic use Receptor, Epidermal Growth Factor / genetics* Retrospective Studies Ultrasonography, Interventional |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 0/Quinazolines; 15663-27-1/Cisplatin; 184475-35-2/gefitinib; 41575-94-4/Carboplatin; EC 2.7.10.1/EGFR protein, human; EC 2.7.10.1/Receptor, Epidermal Growth Factor |
| Comments/Corrections | |
Comment In:
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Chest. 2011 Dec;140(6):1664; author reply 1664-5
[PMID:
22147827
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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