title: Screening for activating EGFR mutations in surgically resected nonsmall cell lung cancer.
abstract: The clinical applicability of screening surgically resected nonsmall cell lung cancer (NSCLC) tumour tissue and serum for activating epidermal growth factor receptor (EGFR) mutation is unknown. Furthermore, the comparative accuracy of inexpensive EGFR mutation tests, mutant-enriched (ME)-PCR and high-resolution melt (HRM) has not been determined. Lung tumour DNA from 522 surgically resected stage I-IV NSCLC and matched serum DNA from a subset of 64 subjects was analysed for EGFR mutations in exons 19 and 21 using ME-PCR and HRM. Additionally, 97 subjects had previous EGFR DNA sequencing data available for comparison. ME-PCR and HRM detected EGFR mutations in 5% (27 out of 522) of tumour samples. Compared to DNA sequencing, ME-PCR had a sensitivity of 100% and specificity of 99%, while HRM had 100% sensitivity and specificity. Six subjects with EGFR mutation tumours had matched serum, where ME-PCR detected mutations in three samples and HRM in two samples. In the cohort of never-smoker subjects, those with EGFR mutated tumours had worse survival compared with wild-type tumours (30 versus 49 months; p=0.017). ME-PCR and HRM have similar accuracy in detecting EGFR mutations but the prognostic implications of the mutations in resected NSCLC warrants further study.
authors.affiliation: UQ Thoracic Research Centre, School of Medicine, The University of Queensland, Australia. bajee.sriram@uqconnect.edu.au
authors.forename: K B
authors.initials: KB
authors.lastname: Sriram
authors.forename: M E
authors.initials: ME
authors.lastname: Tan
authors.forename: S M
authors.initials: SM
authors.lastname: Savarimuthu
authors.forename: C M
authors.initials: CM
authors.lastname: Wright
authors.forename: V
authors.initials: V
authors.lastname: Relan
authors.forename: R E
authors.initials: RE
authors.lastname: Stockwell
authors.forename: B E
authors.initials: BE
authors.lastname: Clarke
authors.forename: E E
authors.initials: EE
authors.lastname: Duhig
authors.forename: I A
authors.initials: IA
authors.lastname: Yang
authors.forename: R V
authors.initials: RV
authors.lastname: Bowman
authors.forename: K M
authors.initials: KM
authors.lastname: Fong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D004252:DNA Mutational Analysis / Q000379:methods* / Q000592:standards*; D066246:ErbB Receptors / Q000235:genetics*; D005091:Exons / Q000235:genetics; D005260:Female; D005629:Frozen Sections; D005820:Genetic Testing / Q000379:methods* / Q000592:standards*; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D044366:Transition Temperature
chemical_list: C512478:EGFR protein, human; D066246:ErbB Receptors